tt d,. 1903
n
7 2b
4 5*
3 33
11
7 21
5 '
3 27
3. Septuagesima Sunday. A/aft. 20 9h. 32m. Day's Length,9h. 42m.
19 5
Paul Morton died, 7911
**
7 25
4 57
4 47
it
7 20
5 2
4 4°
20 M
Chicago CHb Disaster, 1909 **■
«t
7 24
4 59
5 5«
it
7 20
5 3
5 5'
21 Td
J^S$ »n aphelion: tfjjjfl
V£/ra£ Victoria died. 1901
«
7 24
5
6 59
11
7 *9
5 4
6 52
22 W
HE
7 23
5 •
rises
12
7 19
5 5
rises
23 Th
6 ® ©* <I to P«i£«
■*
7 22
5 2
6 25
12
7 m
5 7
6 29
24 Fr
Sen, R. A, Alger died, 1907
**
7 22
S 4
7 47
12
7 17
S »
7 49
25 S»
Cpw7«t-jfVm tffSf, Paul
M*
7 21
5 5
9
12
7 17
S 9
9 7
4. Sexagesima Sunday. Luke 8 9h. 45m. Day's Length, 9h. 54m.
26 S
(m^ K. M. Field d., 1907
*
7 21
5 6
10 23
«3
7 tb
5 10
10 22
27 M
James G. Blaine died, 1893
*■
7 20
S 7
'i 37
13
7 IS
5 n
it 34
28 T11
Ag^Floodin Puis, 1910
\^^-£§th* 1; stationary
A
7 18
5 9
mom
13
7 14
5 '3
morn
29 W
A
7 "7
5 10
49
•3
7 »3
5 14
45
30 Th
Wnt. Goebcl assassinated, 190a
A
7 16
S "
2 I
13
7 «3
5 »S
1 58
51 Fr
Primero Mine Explosion, 1910
<■
7 15
s 13
3 "
"4
7 12
5 ib
3 5
Houseflies breed by preference in horse stables.
Their second choice is the privy.
Their third choice is damp garbage of any kind, even old rags'.
(7)
AIR-SPACE AND VENTILATION.
Every healthy person should have at least 800 cubic feet of air-
space, and every sick person at least 1,000 cubic feet. With this space
provision should also be made for efficient ventilation, for if the air is to
be kept sweet, 3,000 cubic feet per hour per head must be supplied. If
this air be changed (as it will require to be if the cubic space allowed
be less) by ventilation more often than three to four times an hour, an
unbearable draught is created. This cubic air-space should be calculated
after allowing for space occupied by furniture displacing air, and the
larger the superficial area of the room the better. In sick rooms the
floor-space should not be less than one-twelfth of the cubic space. A
room 10x10x10 feet gives a breathing space of 1,000 cubic feet, with-
out allowing for furniture.
The amount of cubic space thus assigned for healthy persons is far
more than most people are able to have ; in the crowded rooms of the
artisan class, the average entire space would probably be more often
200 to 250 cubic feet per head than 800. In the case of soldiers, the
amount of authorized regulation space (600 cubic feet) is below the
standard now given.
HOG CHOLERA.
Hog cholera cannot be prevented. Neither can it be cured. Hog
cholera serum is neither a curative nor a preventive.
But hog cholera serum, when properly administered, at the right
time, prevents the loss of hogs. It does it this way:
When a hog has hog cholera he is afterward immune. That is, if
he recovers. Now hog cholera serum, if given at the right time, helps
him to recover.
The right time to give it is just as soon as possible after the disease
gets into the herd. For, like fire in a forest, cholera sweeps through a
herd taking them as it meets them. If serum is given at that time, be-
fore they get sick, they will have the disease just the same, but few will
die. Afterwards they will be alive, because of the serum ; they will be
immune, because of the disease.
A man can save his hogs from hog cholera very easily if he will try,
but he must first of all get down to work and learn how. For fuller
information, write the State Board of Health.
If you suspect you have hookworms, it won't cost you anything to
find out. Write the State Board of Health.
MOON'S PHASES.
N.M.
L. y
BOSTQh
WE>* 'TOR'S
o a M j 6 o 22 M.
3 34^,114 3 34 M.
9 3 AJao g 3 A
4 rs A,3? 4 '5 A
CHiC*QO
3. H. M,
5 It 22 A.
14 a 34 M.
20 B j A.
n 3 *5 A.
D, D.
M. W.
Historical Events*
' ! ^ a I (5 tf & Adm, Spi-rry d., iqii
LATITUDE
Oi Boston 1 Ncv
England, N. York
State, So, Mich,,
Wticonttn. low*,
Wyo, ind Orrgon,
Sud I Sun I Mood
rises sets flaw
LATITUDE
Of Nc-YotkCitY*
FhUadt.'*. ConiL..
Nc# Jtrtcy, P**.
Ofito, IndUlu. Illi-
nois, Neb, And Cat.
Sud
Sun
sets
Moon
ri&ea
7 >4|5 M| 4 I7ll'4|[7 n'S ^7 1 4 to
5. Qumquagesima Sunday.
I.uks 18
Wh. 2m. Day's Length, Wh. 9m.
2
S
3
M
4
In
5
W
6
Tli
7
Fr
s
Sa
Ph rs&catitrm — Candlemas *&
(J J (I . Geo. W. Child's d.. i8y +
cS&C - Robt, Ulair died. 1746
jtk* Ash Wednesday
ftjft. Gen Gibbon d. iSgG
C in apn^tc
Gen.Juhn K Lewis died, tqoq
A 7
,7 '3'5 "5
7 12 5 '7
7 II 5 18
7 10
7 9
7 8
7
5 «9
; 20
5 22
l_ 2;
s
l6i
6
Si
6
44
Ml-
1
4S
6
Si
7
S3
7 10
7 9
S I( .'
5 20
S 21
5 22
S 24
S 9
5 58
6 3B
sets
5 52
6 S3
7 5+
5. /sf Sunday in Lent
Matt. 4 lOh. 19m. Day's Length. Wh. 25m.
9
10
S
M
] i
12
M
Th
«4
Mr
<I it. .. Gma Hun cock d*. 18S6
d9C: 5«r*Jwl bt. S.
Steamer Ijtrclimeim lost. 1907
jCapt* Ceiolc killed, 1:779
14th. St. Vairntine's Pay
Gen, Lew. Wallace died, 1905
A
7 S
5 24
8 S4
I 14
7 2
S ^7
7
7 4
5 26
9 56
14
7 1
S 2B
2
7 3
S 27
10 59
14
7
s 30
«r
7 1
5 2»
mom
14
° 59
5 3'
#r
7
s 30
° 5 [14
b 17
s 32
:--?
b 58
5 3i
1 15 |i 4
b 50
5 33
«
6 57
5 3?
3 27 14
° 55
5 35
8 54
9 55
10 56
imirn
1
1 10
2 21
7. 2d Sunday in Lent
Matt, /j fOh. 37m. Day's Length, lOh. 43m.
□ 'id- Ja>' Cooked., 1905 <*
Frances K. Will.-u-d died, 1898
r^lJJG Vermont admitted. 1791
Ncill Burgess died. 1510
i?dM. fl in perigee
Edgar W Nye died. 1896
<J in " Washington b.. 173a
tz
b g6
5 33
3 38
M
6 53
5 36
tt
b ss
S 35
4 42
14
6 52
5 37
«
&53
5 36
5 35
14
6 51
5 3*
•IS
b 52
5 37
6 IS
>4
b 49
S 39
«*
6 50
S 38
liM.--
14
6 48
5 41
f^
6 4Q
s 40
6 37
14
b 46
s 42
»*•
47
5 4i
7 56
14
•> 45
5 43
3 3'
4 35
5 28
6 t 3
rise&
6 39
7 56
i7. 3rf Sunday in Lent
Luke rt Wh 56m. Day's Length. 1th. Om.
2\
S
-■4
M
15
lu
2Q
%V
n
Th
2S
Fr
Panama Canal Treaty, ; =04
iV. Mitttkias
defr^- D, E Henderson d.1906
d £r. libra*. on W.
|J«4, N. I.Uldle (1, 1844
LadyiDiiih relieved, iojOD
fr
b 46
S 42] 9 14
14
*
6 44
S 43 <o 31
'3
rH
b 41
5 45
11 47
IJ
rH
6 41
5 4b
mom
13
«
6 40
S 47
1 1
M
*
6 38
S 48
2 10
>3
6 44 5 44
6 42, ; 45
6 4l'5 47
6 39 5 48
6 38.5 49
6 3615 so
9 12
10 28
11 42
morn
O ss
2 3
Lumber spent in building privies will never be needed fur coffins.-
Ilt-allh Bulletin.
-I irginia
<3>
SMALLPOX.
Is the one absolutely preventable disease. Vaccination does it. If
vaccination doesn't "take" try again till it does, and then ran will lie
safe from smallpox.
This young lady believed in vaccination but waited for smallpox
in "come around." It came so stealthily that she was the first in the
community to get it. It was too late then.
MOON'S PHASES.
N.M.
L, ■ >.
H. H,
7 ?! A 7 7 aa A,| 7 6 aa A
3 ;8 A. i; 3 ;8 A. (15 ■ jK A.
;j8M i9 7 5SM.|J9 6 58 M
D. D,
M W.
Historic*! Events.
LATITUDE
Of Barton 1 New
Engumd. N. York
State. So. Mich..
Wt*corL»ln, laws,
Wye. and Oregon.
Sua
rlBri
« H
Hun
Moon
rile*
LATITUDE
Of New York Otr 1
PhtUdtl't, Conn..
New Irrtty. Pi..
Qblo, Indiana. I1U-
nol*. Neb. and Cal.
Sun Sud
rt*e* seta
Moon
riaea
6 36 S 50 3 " |'3 6 35i5 S'l 3 3
I ISa
5 in Q. ,S/. Dirtiiii
l#
9. *tt Sunday in Lent
JoJih 6 lib. 16m Days Length, 11h. !9m.
z
S
3
M
4
In
=1
W
(,
■11,
7
lr
S
Sb
<J7,«. Gen. J. Early d., i8u 4
9 in perihtEian
d$a: dcM
General Strike to Philadel., 1910
ft in perihelion ; <[ in apugee
!?t*. E. Burritt d.. 1875
H. W. Be«her died. 1B87
*f
6 35
5 Si
4 3
12
& 33
5 S^
«f
33
5 Sz
4 45
12
6 32
5 53
**
6 32
5 53
5 i«
12
6 30
5 54
*X
t> 30
5 54
5 45
12
6 29
5 S5
A
6 28
S 5°
6 8
11
6 27
5 57
A
6 27
5 57
sets
11
6 26
5 18
A
6 25
S 5«
6 46! 11
6 24
5 59
3 56
4 39
5 >z
5 4°
6 s
sets
6 46
10. 5th Sunday in Lent.
John 8 T th. 36m. Bnvs Length. 1th. 38m.
9
IO
M 1
i [
'1'u
1 2
W
'.1
J'li
14
'5
It
Si
d?C: <I in Q
Standard Oil Co. acquitted, 1909
tf B r. dang, E., *B° 19': ci 9 «
John P. Alifield died* tgoa
Ben, Harrison d.,, igni
ZiL.ration E*
Bruce crowned .J 30*5
6b tl- B(
4«
6 21
621
5 S9
6
7 48
8 $1
11
10
(3 22
6 21
6
6 1
6 20
6 18
6 16
6 1
6 3
6 4
9 57
«i 5
morn
10
10
10
6 10
6 17
6 16
6 2
6 3
6 4
F3
615
6 13
6 5
6 6
15
i 24
9
9
6 14
6 J3
6 5
6 6
7 47
849
9 53
11 o
morn
9
1 17
7 7. Palm Sunday.
Matt. 37 tth. 56m Day's Length, tth. 57m.
lb
S
'7
M
1 8
Tu
IQ
W
20
Th
21
Fr
22
Sa
jP.r/Mt S'tnttmy A
<JttfG : 5 5UL .», Patrick
Frruch Commune, 1B71
9 gr- brilliancy
Crete blockaded, 1 Bo 7
rfSK tyring ix£ , Good Friday
X§£f32d. 1 in U
«
■j 11
6 7
2 29
9
6
1 1
6 8
tt
6 q
6 S
3 26
9
6
9
6 9
•tt
6 8
6 10
4 «»
8
6
8
6 10
-fll
6 6
6 11
4 46
8
6
6
6 11
ft*
6 4
6 12
5 16
8
6
4
6 12
*»•
6 3
6 «3
5 42
7
<>
3
6 1,1
•>
6 1
6 14
nses
7
6
1
6 14
IS. Easter Sunday.
John 30 t2h, 16m. Day's Length. 12h. 18m.
25
24
s
u
25
26
III
w
27
2S
Th
Fr
29
Sa
East** Sunday
Jules Vcme died. 1905
$ £r. h r I . lat . N * *4 nmtnciati&n
Earthquake in CbilapA, J90S
d inferior
CNew York Riot, jooB w
*
S 59
6 15
8 S
7
5 59
6 15
A
S 57
b 16
9 23
b
5 58
b lb
iH
S 5*>
6 17
10 40
6
s so
6 17
<e
5 54
6 18
11 54
6
5 S4
6 18
<c
5 52
6 20
mom
6
S S3
6 19
«
5 5°
6 21
1 1
S
5 S»
6 20
*
5 49
6 22
i S 8
5
5 49
6 21
8 3
9 «9
"> 35
11 48
morn
o 54
i so
13. Low Sunday.
yohn 30
12h. 36m. Day's Length 12h. 34m.
Aiaaka purchased, ifi6;
<5 S C . Hiram Berdan d„ 1003
6 23I 2 44
6 24 1 3 21
5 48
5 46
6 22
6 23
2 37
3 IS
If preventable, why not prevented? — King Edward VII.
an
PNEUMONIA.
February is one of the worst months for the worst disease, pneu-
monia. This kills more people every year than any other human
disease, and is caused by a small organism similar in some respects to
those causing other diseases with which we are familiar.
The germs of pneumonia get into the lungs through the mouth, but
not every man who has the germs in his mouth will have pneumonia.
If he did, practically all of us would have the disease during the winter.
It is only when the system is "run down" that the germs do their dread
work. These are the things which make pneumonia nourish:
1. Excessive drinking alcoholic liquors.
2. Unusual exposure to extreme weather.
3. Exposure of old persons or persons suffering from other dis-
eases.
4. Living and sleeping in badly ventilated rooms.
To try to avoid it :
1. Do not drink alcoholic liquors.
2. Dress warmly but not too thickly.
3. Do not needlessly expose yourself.
4. Have abundant fresh air in your living and sleeping rooms.
5. Do not have your rooms too hot and then go into the open air
unprotected by wraps.
G. If exposed to extreme or rough weather, and wet or numb,
undress in a warm room, rub off with a rough towel until the skin
glows, then go to bed and stay there several hours.
7. . Avoid overeating and keep the bowels open,
8, Keep your feet warm and your head cool.
9. A moderate amount of brisk exercise in the out-door air daily.
— Kansas State Board of Health.
FRANKLIN AND THE BORE.
Once, in traveling, Dr. Franklin was exceedingly annoyed by a
pedantic bore who forced himself upon him, and made a great parade
of his learning. Franklin stood it as long as he could, and at length,
looking at him gravely, said: "My friend, you and I know all that is to
be known/'
"How is that?" said the man, pleased with what he thought a com-
plimentary association.
"Why," said the doctor, "you know everything except that you are
a fool, and I know that." — Pathfinder.
MOON'S PHASES,
N.M.
L.Q.
B. If
SOtTON
S o i! A,
o 39M.
+ H »'
"ft
W
Th
Fr
Si
D. H. H,
8 a 40 A.
14 o 39 M
» 4 33*.
ag i »M,
a. h. u
e ii «8
• 3 11 39
98 o o
Historical Events.
ILunota Miners' Strike, 1910
<J J fl : <£ in apogee
^ stationary : ^1 stationary
Gad Congress opened. 19 11
c5 B a : <1 in fl
LATITUDB
Of Eoaton 1 New
England. N. Y«k
State, So. Mich.,
P hMWh i Iowa.
Wyo. and Oregon,
Bun
5 43
S 42
5 40
5 38
S 36;
Sua
Kll
6 25
6 26
6 2$
6 29
6 30
Moan
LATITUDB
Of New York City i
PfcUidei'a, Conn..
N«w Itruv. Pa..
Ohio, Indiana, IUI-
nota, Neb. and Cat.
Sun
rlaea
>. M.
3 5°
4 14
4 34
4 52
5 10
S 44
5 43
S 4'
S 39
5 38
Bon
acta
Moon
riaea
6 24
62s
6 26
6 27
6 28
3 45
4 10
4 y-
4 5'
5 10
14. 2d Sunday after Easter. John 10 12 h. 56m. Day's Length, 12h. 53 m.
• bth. DUO
F. T. Baroitm died, 1091
fj ? a . T. F. Ryan d., 1910
in U^ £ stationary
d*2<I- T. L. JohnsoD d„ 1911
a gr. libration E.
Fire in Chelsea, 100S 4%
s
S 35
6 31
sets
3
5 36
6 29
5
5 33
6 32
7 48
2
5 35
6 30
we
5 3'
33
8 57
2
5 33
<j 32
##♦
5 30
<> 34
10 6
2
5 3'
° 33
w
5 28
35
II 15!
1
5 30
*» 34
P»
5 26
6 36
morn
t
5 28
6 35
«
5 as
6 38
O 221 I
5 27
6 36
sets
2 45
8 52
10 o
11 8
mom
O 14
75. 3d Sunday after Easter. John t6 13 h. 16 m. Day's Length. (3h. 12m.
13
s
14
M
'S
Tu
16
W
w
Th
iS
Fr
19
Sa
3 /J/*.
DUI0: dW<r
Sen. ButJer d. 1909
Bering Sea Treaty, 1896
Mafelting relieved, 1900
Sanlord C. Hill died. 1871
J in y : a in perigee
ill aphelion
H
5 23
6 39
1 2a
1
5 25
<> .57
HK
5 21
6 40
2 7
O
5 24
6 38
•4S
5 20
6 41
2 45
O
5 22
o 39
■*
5 18
6 42
3 17
f.
S 20
6 40
tt
5 «7
*> 43
3 43
O
5 »9
6 41
*
s 15
b 44
4 b
I
S "7
42
*
5 "4
45
4 29
1
5 "-'
6 43
1 '3
2 1
2 40
3 «3
3 4»
4 5
4 3°
f6. 4th Sunday a fter Eas for. John 16 13h . 34m. Oar's Length. 13h. 30m.
20
s
21
M
22
Tu
23
w
24
Th
2;
Fr
26
So
3Qih. C- Darwin d. t iBfca
_^ jFMark Twain died, 1910
Joseph Jefferson dwdL roos
tf gr. he] » Iat. S. ^/a George
^ 9 inferinr
J-r, J-fcir* «
H$T^4- B. Bj5msaad.» jqjq
rises
1
5
M
8 12
1
5
'.5
9 3>
1
5
11
ID 42
2
5
10
«« 45
2
5
9
morn
2
<
7
37
2
5
b
rises
8 7
9 25
™ 35
11 37
mom
o 3°
77. Rogation Sunday.
John 16
13 h. 53 m. Day) Length, 13k. *7m.
27
S
28
M
29
Tu
30
W
Coac
aft*. D S
Stuart Robson died, 1903
a in apogee
6 54) 1 18
6 55 " 5"
6 56 2 17
6 58] 238
5 4|6 51
5 3p 52
S 26 S3
5 °l 6 54
1 12
1 46
2 13
2 35
If all ownerless dogs were killed, there would be no more hydrophobia. Then
valuable dogs and children would be safe. Let lovers of dogs, and of children,
take note.
(13)
WHAT EVERY ONE SHOULD KNOW ABOUT
HOOKWORMS.
1. The largest hookworm is only about three- fourths of an inch
long— the male a little smaller.
2. The adult hookworms live in the alimentary tract in human
beings.
3. They lay large numbers of eggs in the alimentary tract.
4. These eggs are passed out in the stools.
5. Where sewage is properly disposed of the eggs are destroyed
and no harm is done.
6. But when no privy even is used the eggs are deposited on the
ground where they hatch, and
7. In a few days the baby hookworms are ready to attack the feet
of any barefoot child that chances to come along,
8. This they do by burrowing into the skin, producing what we
know as ground itch.
9. They get through the skin into the circulation, through which
they pass till they reach the lungs.
10. There they are coughed up and swallowed.
11. When they reach the intestines they grow up to be adult hook-
worms, and the child begins to get pale.
12. This child in turn begins to deposit hookworm eggs as the
one before him did, and so on in an endless cycle.
13. If you suspect your child has hookworms write the State
Board of Health.
COMMUNAL CRIME
The man who destroys the life of another, commits the highest of
all crimes. The community or nation which, with the knowledge and
means of prevention at hand, will permit the lives of thousands of its
people to be blasted and destroyed by avoidable disease, is guilty of the
same high crime. One may be due to criminal intent and the other to
criminal negligence, but the result is the same. — The Human factor.
The husband of a woman noted for her extravagance in dress had a
terrible dream. He met a strange collection of animals — several foxes,
a beaver and some seals — and they had no coats. He wondered, and
then the beaver explained: "We were skinned for your wife's furs."
The man smiled. "So was I," he said. — Pathfinder.
MOON'S PHASES.
N.M.
r'.M.
L. y.
SOI TON
a. i[. h.
6 q J4 M
■a a 4 «M
»o jilM.._
»7 T 4 A-|»7
If. M.
6 45 M
i tSM
7 4 A
6 a 24 M.
'3 S 45 M.
20 i iS M.
a? 6 4 A.
Historicit Events.
Atctmian. St.PMilif. St. Jama
defa: flinQ
Farragut in New Orleans, rS6i
LATITUDE
Of Bolton 1 Nn
England. N. York
State, So. Mich.,
Wltconilf"., Iowa,
Wyo, and Oregon,
San
risa
San
■eu
LATITUDE
Of Nt- York City r
Pbludtl'a, Conn.,
New J«twy, Pa..
Ohio, Indl.ru. UU-
nol*. Neb. end Cel,
Bun
Ilea
finn
4 5"
4 S4
4 S3
6 59 1
7 °
7 il
2 57
3 '5
3 33
4 59
4 58
4 57
6 5 S
6 56
6 57
afoot]
rlvei
2 55
3 '4
3 34
18. Sunday after Ascension. John 15-16 14h. 10m, Day's Length, 14h. 3m.
. 1910
d0« = 69«
If stationary
•VA, Edward VII.
(399- iJ-ml* bom. 1265
# gr. hel t late S fi
Juarez surrendered* igi!
s
4 52
7 2
3 51
3
4 55
6 58
#*
4 5°
7 3
4 12
3
4 54
7
#*
4 49
7 4
sets
3
4 5.1
7 1
ft*
4 48
7 5
9 to
4
4 5'
7 2
w
4 47
7 to
IO 14
4
4 5>
7 3
M
♦ 4<>
7 8
«i is
4
4 49
7 4
M
4 44
7 9
Illi.il II
4
4 4B
7 5
3 53
4 15
sets
9 o
10 7
11 8
" 59
1 9. Pentecost— Whit Sunday. John 14 I4/i.27m. Day's Length. Hh. 19m.
II
S
12
M
1.1
Tu
14
W
K
Th
if
Fr
17
Sa
6W< ■ Pent&ost Sunday
S Ufttloojuy
3tjtk 9 stationary
Battle Crown Point.. 1775
fl in perigee
tf in ^ * M af eking relieved. 1900
Lop<z in Cuba, 1850
«
morn
41
1 «5
1 48
2 7
2 31
2 56
20. Trinity Sunday.
John 3 14h.41m. Day 's Length, 14h. 32m.
tf In perihelion
Wm. E Gladstone died. 1898
|MWA. J in U
A. 'I otireee died, 3905
O/iu Ciriai. tJgr.no.W. w
(Jl( « . L, Fairchild died, 1896
Queen \ tctoria bom, 1819
f*l
4 36
7 »7
3 18
4
4 40
7 12
iH
4 35
7 18
3 45
4
4 40
7 13
<C
4 34
7 19
rises
4
4 39
7 14
*
4 33
7 20
9 30
4
4 3«
7 15
*
4 32
7 21
10 27
4
4 37
7 16
*
4 32
7 22
11 13
3
4 3<>
7 I?
ft
4 3'
7 23
It 49
3
4 36
7 18
3 21
3 50
rises
9 23
10 20
it 6
11 43
21. 1st Sunday after Trinity. Lute r6 t4h. 54m. Day's Length. 14h. 44m.
«S
s
20
M
27
To
ai
W
2<J
Th
1°
Fr
3'
Sa
6&<t: It in U
Steamer Plnvoiae sunk. 1910
CS7**. Dr Koch d„ 19m
5 in Q; t in apogee
dhO: a in n
9 IF- brill. Dtceraiien Day
4 30
7 24
morn
3
4 35
7 19
morn
4 29
7 25
O 18
3
4 34
7 19
13
4 28
7 2d
O 41
3
4 34
7 20
38
4 2S
7 26
I I
3
4 33
7 21
59
4 27
7 27
I 20
3
4 32
7 22
I 19
4 27
7 28
* 37
3
4 32
7 23
' 37
4 26
7 29
« 55
3
4 31
7 23
1 57
The campaign for better health has so far been little more or less than one
large campaign for cleanliness.
(15)
From FLIES and FILTH
to FOOD and FEVER
133®!? June
^S^&TOgDQ^a 1913 ift^C^
jy^&y
MOON'S PHASES.
[rt
Z
LATITUDE
Of Boito n t N« w
LATITUDE
Of New York Cirri
MM
HCW ¥B#HC
CHJCAOO
i
. H. M.
D. It, 11.
3. IT. H.
England, N. York
H
Phtlnitl'l, Conn.,
N.M.
4 J 57 A.
4 * 57 A.
4 I 57 A*
1/1
Statt, So. Mich.,
New Jtrwy, Pju,
l, y, 3
t 11 37 M.
it it 37 M
11 10 37 M.
rn
Wtsconafo, Iowa,
Eh
Ohio, Indiana, 1111-
8 . 9| A..
S 41 A.
r8 054 A.
96 41 A.
18 11 S4 M.
36 11 41 M.
Z
O
5
Vyo. and Ore eon.
nota, N«n. and Cal*
D. D.
Boa
SUQ
Moon
Sun
Son
Moon
Historic*! Events.
31
rises
HU
rlstt
riaea
•el*
rises
H Id
H. It
H. U
H.
H M
II. K
H, U.
22. 2d Sunday after Trinity. Luke 14 fS/i. 4m. Day '9 Length. Hh. 53m.
1 S
6 S < : (JOG superior
#»*
4 26
7 if
2 38
2
4 31
7 34
2 18
2 M
in perihelion
#P
4 25
7 30
2
4 3°
7 25
2 42
3 1"
fl pr Gbr&iion E
•#•
4 *5
7 3"
3 *
2
4 3°
7 26
3 »<
4 W
fl^M. 6*i<I: d«<I
h
4 24
7 32
sets
2
4 30
7 26
seis
5 lb
^^■PSLephru Grant d iwa A
w
4 24
7 32
9 7
a
4 29
7 27
9
6 Fr
Memphis taken* 1S69
tf
4 24
7 33
10 2
2
4 29
7 28
9 55
7 S*
d*r«
tt
4 23
7 34
10 46
1
4 29
7 28
10 40
25. 3d Sunday after Trinity Luke t$ ISh. Jim. Day's Length, 15h. Om.
s s
Norway weeded* 1905
•n
4 23
7 34
11 22
t
4 29
7 29
11 17
9 M
tj in perigee
•*
4 23
7 35
11 50
1
4 28
7 29
it 47
io Tu
Steamer Slavonia wrecked, 1909
j**
4 23
7 3*
morn
1
4 28
7 30
mom
ti W
J gr. brf. lat, N.: C "» U
N»
4 aa
7 3<>
O 14
1
4 28
7 3«
12
13 Th
lr
4 aa
7 37
O 36
4 28
7 31
36
[3 Fr
War Revenue BUJ signed. lyoS
*
4 22
7 37
7 38
O 57
4 28
7 31
58
4 Sa
Arnold died, tSoi
r*i
4 22
I 20
si
4 28
7 32
1 23
24. 4th Sunday after Trinity : Lukt 6 15 h. J 6m. Bay's Length. ISh. 4m.
S S
Ste. Gen Slocum burned, 1904
rh
4 22
7 38
I 46
4 2.S
7 32
1 50
6 M
Gen- Bobriknff ahoi, 3904
*
4 22
7 3«
2 17
4 38
7 33
2 22
7 Tu
Gen . Gomez died. 1905
ME
4 22
7 39
2 55
1
4 28
7 33
3 1
8 VV
jSflWM. ([ gr. Hbnt. W. W
HE
4 22
7 39
rises
i
4 28
7 33
rises
9 Th
*
4 23
7 39
9 *■
1
4 28
7 34
8 59
M5 Fr
Justice Moody retired. 1910
*
4 23
7 40
9 4"
1
4 a8
7 34
9 40
it Sa
@ enters !j. Sutttnt+r stgint
**
4 23
7 40
10 17
1
4 29
7 34
10 12
25. 5th Sunday after Trinity. Luke 5 15 h. 17m, Day's Length. 15h. 5m.
jj S
6 VestmC
*»
4 23
7 4°
«o 43
2
4 29
7 34
"> 39
.
13 M
Wehnun Mine Disaster, 1900
«X
4 23
7 4°
ii 5
2
4 29
7 34
11 2
:4 t u
4 in apogee. £f> ^twfc*. Baptist
A
4 24
7 40
11 24
2
4 39
7 35
11 33
SS W
VL,a6/*. D»v. Devi, d.. 18B6
A
4 H
7 4°
it 42
2
4 3°
7 35
11 42
;
!b lh
S
4 24
7 40
II 59
3
4 3°
7 35
mom
!7 Fr
Joseph Smith shot, 1844
S
4 25
7 40
morn
3
4 3°
7 35
i8 Sa
Sen. S, D. M'Enery died. 191a
4M
4 25
7 40
17
3
4 3«
7 35
O 19
20. fffft Sunday after Trinity. Matt, j ISh. 15m. Day's Length f5h. 4m.
;
19 S
<Jd*« Si. frttr and St. Pant
#r
4 25(7 40
38
3 1
4 3'j7 35
42
to M
A 2 <t A. J Dreiel d.. 1893
#f
4 26(7 40
1 4
3 1
4 32|7 35
Stagnant water doesn't cause malaria, nor decaying vegetation typhoid.
They offend the nostrils but make no one sick.
(17) ,
HOW FLIES TRANSMIT TYPHOID.
In two ways. The first and most important is as follows : Flies
breed in privies. Flies bred in privies that have been used by typhoid
patients get infected as maggots. They then excrete typhoid germs the
rest of their lives. Fly-specks from such infected flies have typhoid
germs in them. Such fly-specks deposited on food is one — probably
the chief— way in which typhoid fever is spread in this Stale.
The other way is for flies to visit typhoid excreta and gel the germs
on their feet and mouths and then walk over food.
Fly-borne typhoid fever accordingly may be prevented by so dis-
posing of typhoid excreta that flies can not get to it, either to lay eggs,
or to feed.
All closets should be fly-proof.
DISEASES PREVENTED BY SCREENS.
1. Malaria, by keeping out the Anopheline mosquitoes.
2. Filariasis, by keeping out the Culex mosquitoes.
3. Yellow fever, by keeping out the Stegomyia calopus mosquitoes.
4. Dengue ( ?) , by keeping out the Culex fatigans mosquitoes.
5. Sleeping sickness (in Africa), by keeping out the tsetse fly.
6. Infantile paralysis (?), by keeping out the stable fly, Stomyxis
calcitrans.
7. And by keeping out the housefly much of the typhoid, and
bacillary dysentery is prevented.
8. Much profanity is also prevented.
If wire costs too much, cheesecloth does almost as well.
CONTAGION
Little George had heard a great deal said about disease germs, sucb
as tuberculosis, etc. One day the family were at dinner, and George
wanted a drink of water. The tired mother said :
"Drink out of your uncle's glass, George ; he is through eating."
The Httle fellow commenced to cry, and said :
"I don't want to; I'm afraid I will catch the backache." — Eustis
take Region.
I live in a constant endeavor to fence against the infirmities of ill-
health and other evils, by mirth ; I am persuaded that every time a man
smiles — but much more when he laughs- — it adds something to his
fragment of life. — Sterne.
N.M
f.H,
L, Q
D. D.
M. w.
o 6M.
4 37 A.
i 6M.
4 »M.
4 o o.M
•° 4 37 A
i3 > CM.
36 4 »M
0K1CHO
S. H. H.
3 11 « A.
10 3 37 A
iS d 6 M.
aft 3 59. M,
Historical Events.
6 h fl - John Hay die J, 1905
Frc». Garfield ahot. 1 SSi
• j'/. $ in aphelion A
jtk. Indepcndencr Day
8TIQ: 69<t
LATITUDB
Of Boatan 1 Kl.
Eofknd, N. Yoik
Snitt. So. Mich..
WUtonain. lavi,
Wyo, and Oregon.
Suit
rises
a. u
Sun
Set*
M- H
Moon
rtaea
' 37
3 19
3 '4
sets
9 20
LATITUDB
Of NiwYoskCtty.
PMfahft . Co-tin..
ttrw Iukt, Pa...
Ohio. Indian*, Lii-
nota. Nab.andCsI.
Sun
Sun
Hood
rlaes
H. H
4 3'
4 32
4 33
4 33
4 34
7 35
7 35
7 34
7 34
7 34
1 43
3 26
3 31
sets
9 '5
27. 7th Sunday after Trinity. Mark 8 ISh. 10m. Day's Length. 14h. 59m.
5 in (J: d in perlgm
U gr. clang. E.. a6° 13*
John Morgan's Raid. 1S63
4 in y. Lord Ripon d„ 1909
3 [Oik. Columbus b., J447
A dm. AmOTen died, 189 5"
C. S. Rollm hilled. 1910
9 5 1
IO 17
10 40
tl 2
11 24
11 49
mom
9 47
10 i;
10 39
» 3
11 26
11 53
mom
25. tftt Sunday after Trinity. MaU* 7 /5A. Qm* Day's Length, !4h. 52m.
13
S
14
M
IS
Tn
16
W
'7
Th
18
Fr
'9
Sa
Oscar Erbslocb killed. 1910
<l gr, libralioa \\\
Cawnpore Massacre. 1B57
in aphelion : .(J7| <| 9
Angela Heilprin died. 1907
Battle of Winchester. 1864
iH
4 34
7 36
18
1
4 39
7 31 1
*
4 35
7 3 b
53
4 40
7 3»
*
4 3* 1
7 35
1 36
6
4 41
7 3°
*
4 37
7 34
2 28
6
4 42
7 29
*
4 3*
7 34
3 29
6
4 4»
7 29
*X
4 3*
7 33
rises
6
4 43
7 2«
j*
4 39
7 32
S 46
b
4 44
7 28
o 23
59
* 43
2 35
3 36
rises
8 42
25. 9th Sunday after Trinity. Luie 16 t4h. S 2m. Day's Length,! 4b. 42m.
20
S
21
M
2?
Tu
*\
W
*4
'III
H
Fr
M
Ha.
(J stationary
d 9 *! - Bisb* Potter died, 1908
<I In apogee
( in ■"), Da Lament died. 1905
Geo. t~ McLftwa died, 1907
Cat. *.««
iblh. R. Fulton b.. 176s
9 8
9 28
9 46
10 3
10 21
10 40
'i 3
5
26
9
9
9 45
10 4
10 23
10 43
11 7
50. 7 fltt Sunday after Trinity. Luke iq Ha. 38m. Bay's Length. 14h. 30m.
Sett. Edm, W. Pettus died. 1907
dcfC R- L. CoUyer d. r 1890
8 & 0: 6 h «
(JSfl- Bismarck d, 1898 A
John G. Carlisle died. 19 10
**
* 47
7 *S
II 32
6
4 51
7 21
m
4 4«
7 24
morn
b
4 52
7 20
»
4 49
7 23
9
b
* 53
7 "9
»
4 5°
7 22
57
6
4 54
7 IS
tt
4 51
7 21
1 59
b
4 55
7 «7
11 37
moni
15
1 4
2 6
"What has your boy learned at school so far this term ?"
"He has learned that he'll have to he vaccinated, that his eyes aren't really
mates and that his method of- breathing is entirely obsolete," — The Pathfinder.
(19)
TETANUS OR LOCKJAW.
A very fatal disease is tetanus, or lockjaw. A very insidious disease.
You first find you have it, and then remember some wound you received
a week or two before. Possibly a nail in the foot. A splinter in the
finger. A slight wound from a blank cartridge while celebrating the
Fourth of July.
For all of these have furnished their share of tetanus cases.
A few years ago it was shown that tetanus antitoxin would prevent
tetanus, just as vaccination will prevent smallpox. But with this dif-
ference: that one vaccination will usually prevent smallpox for life,
while one immunization against tetanus doesn't last very long.
There is one other important difference, one should get vaccinated
against smallpox first opportunity, but not against tetanus till the
suspected wound is received. In neither case should one wait till the
disease asserts itself.
But tetanus antitoxin costs money and it takes a doctor to give it,
and- a doctor costs money.
Hence trivial wounds are generally disregarded, and this disregard
is sometimes fatal. Don't do it.
Treat all wounds as though they were dangerous — some of them are.
and we don't know which. The first injunction is :
Don't fool with blank cartridges, to get any wound*.
But if you do fool with them, and then get hurt, sec a doctor — he
will tell you whether you need antitoxin.
In 1903 some four hundred deaths in the United States were caused
by Fourth of July accidents. Just think! That is as many deaths as
occurred* from smallpox last year, and both preventable, one" by an-
titoxin, the other by vaccination.
If you can't pay for tetanus antitoxin, you can get it just the same —
ask the family physician or druggist to tell you how.
Father was walking to Sunday-school with little Johnny" and endeav-
oring to improve the time by teaching Johnny his Golden Text, the
words of which were : "Whatsoever a man soweth that shall he also
reap."
Johnny repeated it after his father several times and seemed to
have mastered the correct wording. As they drew near the Sunday-
school the father gave Johnny his last rehearsal. "Now, son," he said,
''let's have the Golden Text once more without any help from me,"
This is what he got from Johnny : "Whatsoever a man sews always
rips." — Harper's Bazar.
MOON'S PHASES.
N.M.
F. Q.
F M.
L. O.
N.M.
BOSTON
2 7 sBM.
8 xi j A.
16 3 »7 A.
24 7 18 A.
31 3 38 A.
MEW YtKMe
9 7 j8M.
811 3 A.
16 3 «7 A.
24 7 18 A.
3» 3 j8 A.
> e 58 M.
8 ia 3 A,
1$ J 17 A.
14 6 18 A.
31 a 38 A.
Historical Events.
LATITUDE
Of BoMon 1 New
England, N. Y«k
Sun, So. Mich.,
Wllconatn, bwi,
Wyo. And Oregon.
Sun
licet
Bun
KUI
Moon
rim
LATITUDE
Of Ntw YorfcCitvt
Phtladcl'i, Conn-.
Nrw Tnacy, p*,.
Ohto, Indtlnj.. ItU-
acrtm, Ntb. and Cal.
Ban
Bun
Moon
lira.
Itt
1 20
7 >9
3 <3
sets
4 5&
4 57
7 16
7 15
3 19
sets
3/. 7Ttt Sunday after Trinity. Luke 18 14h. 24m. Day'* Length. 14b. 16m.
1
S
4
M
5
Tn
6
W
7
11)
8
Fr
9
Sa
4 in perigee
^ fl © inferior
gr, faet L11. S. <I En fj
Wn, Kemmkr executed, 1B90
Cm, Miles retired. 1903
38th. Sen, Fryc d.. 19 ti
John. W. Giiic* died, iqji
"*
4 54
7 18
8 18
6
4 5«
7 14
it*
4 S5
7 16
8 43
b
4 59
7 13
•*
4 56
7 IS
9 6
b
5
7 12
fr
4 57
7 14
9 28
b
5 1
7 10
*
4 58
7 13
9 52
6
5 2
7 9
A
4 59
7 "
10 19
6
S 2
7 »
rH
5
7 10
'o 53
5
5 3
7 7
8 is
8 42
9 6
930
9 55
10 24
10 59
32. 7?f A Sunday after Trinity. Mark 7
l4h. 8m. Bay's Length, 14h. 1m.
10
S
II
M
12
To
'?
\Y
'4
Th
li
rr
16
Sa
C gr. Hbratioa W.
Lopez in Cuba, 1857
stationary
C. P. Huntington died, tooo
^A. J.J.lnealhd., .900
ft
•7 9 n 34 5 5 4 7 5 " 4«
aioni
o 23
t 20
2 24
3 31
rises
5 5
5 6
S I
S 8
5 9
5 10
7 4
7 3
7 1
7 o
6 59
6 57
morn
30
1 27
2 30
3 3 6
rises
33. 13th Sunday after Trinity. Luke 10 13h. 51m. Bay's Length. 13h. 45m.
17
s
18
M
19
Tu
:o
W
21
Th
■a
Fr
M
>a
Railway Strike In England, 191 1
Admiral Evans retired, T908
Tseng Tan Mine Disaster, 1907
Gen. Krans Si gel died, 1902
§ gr. elong. W„ iS^a^
Commodore Perry died. iBao
6 59
6 57
6 56
7 33
Vt
8 26
8 45
9 6
9 31
7 31
7 49
8 8
8 27
8 48
9 10
9 3 6
34. 14th Sunday after Trinity. Luke if 13h. 32m. Bay's Length. 13h. 27m.
24
S
z<,
M
26
To
27
W
28
Th
29
Fr
10
Sa
6hf-
Storm
§!
gr. libradon E.
Storm at Charleston, igis
5 in penheLion : <59$
10 4
10 47
11 41
mora
O 47
» 4
3 27
to 10
10 54
11 49
mom
o 54
2 10
3 3'
35. 15th Sunday after Trinity. Matt, 6 13b. 14m. Pay's Length 13h. 10m.
31 I S I Otorgt Wm. Curtis dir d, i8oa |f|5 23I6 37| sets || o |] $ 2S|6 35 1 sets
Health is the state of not knowing you have it.
(211
INTERMEDIATE HOSTS.
A person suffering from diphtheria is constantly giving off diph-
theria germs. If these germs, by any accident, get transferred to the
mouth of a healthy child they are likely to set up another case of diph-
theria. Hence it is dangerous for well children to associate with one
that has diphtheria. The same is true of measles, whooping cough,
scarlatina, mumps, chickenpox. It is also dangerous to associate with
smallpox cases unless one is vaccinated. In that event one is safe
against smallpox, no matter who he associates with.
These diseases are all transmitted directly from person to person.
But there is another class of diseases in which the parasite has two
hosts — -one when it is a baby parasite, and another when it is grown up.
The malarial parasite for example. It spends its babyhood, if it may be
spoken of as such, in the human being, but its adult life is passed in
the mosquito.
When a parasite has to have two hosts, one is called the definitive
and the other the intermediate host.
The diseases in which the parasite requires two host* are not trans-
mitted from person to person. That is why one could «3eep in the bed
with a case of yellow fever, or malaria with perfect safety — provided
the mosquito host is excluded.
SEWAGE BORNE DISEASES:
Typhoid fever,
Asiatic cholera,
Bacillary dysentery,
Amoebic dysentery.
Hookworms,
Cochin-China diarrhoea,
Several forms of tape worms,
And many diarrhoeas :
all of which will be prevented by the proper disposal of sewage.
Little by little the realization is growing that it is the living environ-
ment of man which brings disease to him. The inanimate disease
carrier is daily becoming less of a bugaboo, and the human, the animal,
and the insect germ vehicles are coming to be recognized as the great
disseminators of suffering and death. — Rucker.
MOON'S PHASES.
J:S:
SOSTOM
D r H M.
7 8 6M,
IS 7 40M,
»3 7 30 M,
*9 " s; A
D. B. Iff.
7 B 6M.
15 7 46M.
13. 7 30 M.
39 ■! 57 Ah
7 GM,
6«6M,
30M
»o 57 A,
Historic*! Events.
G in ^ ; £ in perigee
Napoleon [] I. surrendered, 187a
ad Eruption of All. Pdee, ioay
If stationary
Portsmouth Treaty signed, 1905
Pren. of cKinley shot, igoi
LATITUDE
Of Bolton 1 N«w
BngUnd, N. York
State. So. Mich.,
Wiacoiiain, Iowa.
Wyo. and Oregon.
Sun
rlaea
Sun
Moon
tela
LATITUDE
Of NtwYojkCttyi
Phtladal'a, Conn..
New jersey. Pa..
Ohio. Indiana. Illi-
nois, Neb. and Cal.
Boa
1. at
7,6
7 30
7 54
8 21
8 53
9 32
S 26
5 27
5 28
5 29
5 3°
S 3>
Moon
Htl
7 6
7 3'
7 57
8 2S
8 59
9 39
3ff. tSth Sunday after Trinity. Luke 7 12h. 53m. Oay 's Length. 12h. 5 1m.
7
S
8
M
Q
Tu
to
\v
it
Tk
12
1-r
' ,
Sa
37*A. 4 gr. Hbration W.
9 gr. beL lat. N, w
d If d . Gen. M'Cook A.. 1909
D h G- Penr'» Victory, iS 1 3
9 mil: dSfl
Cornelius Vanderbih died. 1899
U. S. Constitution ratified, T7SS
*
5 31
6 24
10 19
2
5 3^
6 23
*
5 32
6 23
11 14
2
5 33
6 22
*
S 33
6 21
morn
3
5 34
6 20
*
■» 34
6 19
16
l
5 35
6 18
■A
S 35
b 18
1 22
3
5 3<»
6 16
<*
S 36
6 16
2 28
4
5 37
6 IS
A
5 37
6 14
3 33
4
5 3*
6 13
10 26
11 21
mom
23
1 38
2 33
3 36
37. 17th Sunday after Trinity. Lukt 14 12h. 34m. Day 's Length, 12h. 33m.
14
S
I*
M
16
Tu
'7
W
iS
Th
TO
Fr
20
>a
®Pres, M cKinley died, i.joi
tj?h. f in apogee
d 9 © superior
Ml. Cents Tunnel opened, 1B71
(f in ^, Delhi taken. 1857
Prca. GarfieJd died. iSSi
Steamer Olympic Collision. 19-11
3*
39
.10
41
42
5 43
5 44
6 121 4 36
6 III rises
6 32
6 50
7 10
7 34
8 4
4
5 39
M
5
5 40
b
10
5
5 4i
6
S
5
5 42
7
s
5 43
b
5
b
5 44
b
3
7
5 45
a
1
4 3«
rises
6 33
6 52
7 13
7 39
8 to
38. 18th Sunday after Trinity. Matt, zi 12b. 14m. Bay's Length. 12h. 14m.
21
s
22
M
2?
Tu
24
W
*5
Th
26
r-'r
^7
Sa
Si . Mallhnu
(5 b (f ■ Robe. Hoe died, 1909
%$d. Autumn begins A
P. 5- Gil more died, tScja
d^Ftt. J- M- Palmer d., 1900
Lalcadio Hcam dlcd T 1904
(j 9 tf - Geo. Chavez d.„ 1910
S=J
5 46
8 41
7
5 4°
6
w
5 47
s s«
9 29
7
■i 47
5 <;«
H
5 48
5 5"
10 29
8
5 4«
5 5°
M
5 49
5 55
II 40
8
S 49
5 55
•K
S So
5 S3
mom
8
5 5°
5 53
*
S 5«
S 5«
O 58
9
5 5*
5 51
•*
S 52
S 49
2 19
9
5 52
5 5°
8 48
9 37
10 36
11 46
mom
1 3
2 23
39. 19th Sunday after Trinity. Matt 9 11h. 55m, Bay's Length 11h. 55m.
28 iS
29 ;M
3o|Tu
Tbos. F. Bayard died, 1898
r*.fJinpcr. St.Michittl
stationary : rj 9 fl
1 qos. r .
5 53
S 54
5 55
S 48
5 40
5 44
3 40
5 »
sets
9 I
5 53
5 48
3 42
10
5 54
S 46
5 1
10 1
5 55
5 45
sets
A ticky cow is a sick cow. She has chronic Texas fever. Wouldn't you
Tather drink milk from a healthy one?
(23)
HEAT EXHAUSTION.
Though this condition is caused and prevented in the same way as
sunstroke, it is really quite different from it. Heat exhaustion is just
what its name states — exhaustion or collapse due to excessive heat.
Symptoms :
Great depression and weakness.
No unconsciousness.
Face pale and covered with clammy sweat.
Breathing shallow.
Pulse weak and rapid.
Treatment :
Send for doctor.
Remove to cool place and have patient lie down in most comfortable
position with clothing loosened.
No cold externally, but may sip cold water.
Stimulants, as tea, coffee, aromatic spirits of ammonia or small
amount of brandy or whiskey with a good deal of water.
WE SHOULD THINK SO.
Here are some of the* things your child should be able to do when
he is seven years old, according to standards laid down by scientists at
the hygienic congress at Washington:
Count to 13, touching an object representing each progressive
number as he counts.
Repeat the days of the week.
Make change in simple sums.
Recognize the principal colors.
Tell time.
Pick out missing details in pictures.
Draw in the missing details.
If he can't do all these things, he is retarded in the development for
which each act, according to psychologists, is an expression. In that
case special care should be given to bis diet, play, study and general
bringing-up, and he should not be forced to compete with normal
ch ildren . — Pathfinder.
Weeds have more to do with the health of the community than
flowers, but people who cultivate weeds instead of flowers cultivate
things that make for sickness instead of health.
MOON'S PHASES.
D. D.
M W.
W
Th
Fr
a, M-
8 46 A
I ;M.
5 S3 A.
a ag M .
D. If. II.
6 8 46 A-
tj 1 jll
» S 53 *-
g aaM.
o 7 M,
4 53 A
8 aoM.
Historic a! Events*
Postal Special Delivery, 1685
51=13: Dcf©: O^©
Revolution Id Portugal, 1910
Tripoli bombarded, tan
LATITUDE
Or Barton t N*w
England, N. York
Butt. So. Mfch..
Wisconsin,, lowm,
WytP. ind Oregon.
Sun
5 5 t
5 58
5 59
6 a
8UD
Htl
S 43
5 4»
S 59
5 371
LATITUDE
Of New York Cityi
PhUidet'a, Conn.,
New Jtnty, Pi.»
Ohio. Indiana, till*
noli. Neb. and C*I.
Bun
rlrfei
1. ■
Hill!
HU
H. ■
6 18
6 49
7 26
8 11
5 56
S 57
5 58
5 59
5 43
5 4i
5 4°
5 38
Ktl
■; K
6 21
6 54
7 3«
8 iS
*0. 20tt Sunday after Trinity. Matt. 22 lib. 35 m. Day 'a Length, 11 h. 37 m.
5
6
S
M
7
8
Tn
VV
9
10
TL.
Fr
11
Sa
3<f gr libra t ion W . v
Oliver W. Holmes died. 1894
d & C . Chicago Fine, 3871
Cornelius N. Bliss died, 191 1
Justice Hughes Ins! ailed. 19 to
Great Strike m m Paris, tqto
i
9 6
10 8
ti 14
mom
20
1 25
2 28
5 32
9 '4
10 15
11 so
morn
25
1 29
2 3 1
41. SUt Sunday after Trinity. Jokn 4 1th. 15m. Bay's Length. fib. 18m.
11
s
■ ;
M
14
lu
15
VV
16
Th
17
Fr
iS
Sa
H is apogee : £ la aphelion
£ stationary
®9 Id perihelion
/JTA. Sen. DollWer dLlo-ID
Taft and Diaz met, 1910
Julia Ward Howe died, 19 10
St. Luke, EtMiirgrfist.
A
6 9
5 ^4
3 3"
'3
6 7
s 25
3 31
X
6 10
S 32
4 3'
14
b 8
5 24
4 31
X
b 11
5 2I
5 33
14
b 9
5 22
5 32
2
• '3
5 >9
rises
14
b it
5 *«
rises
*»»
6 14
S '7
5 39
14
6 12
S <9
5 43
4H»
6 is
5 it.
b 7
IS
b 13
S '»
b 12
PI
6 lb
5 14
6 412
15
6 14
5 •&
b 48
42. 22d Sunday after Trinity. Matt. 18 tOh. 56m. Day's Length, tth. Om.
10
S
■a
M
21
Ta
22
W
*1
Th
24
Fr
23
Sa
(Jlj <f . Eug. Ely tilled, 1911
Dmdd B. Hill died. 191a a
Cd<ffl
*»* awe: d(pa
John R. Walsh died, inn
Judge R. W. Peckham d„ 1900
Grant Allen died, 1805
7 26
8 21
9 27
10 40
11 57
morn
' 'S
5 IS
5 '3
7 33
8 28
9 34
ta 4b
morn
1
1 IS
43. 23d Sunday after Trinity. Matt. 33 Wh. 37m. Day's Length. 10b. 42m.
4 in H. Gen. Howard d.. 1909
OS©: (J ? d : t! in perigee
B^^.SA Sftt&M nttd Si, Jud*.
^^^F 29th. Jos. Pulitzer d. 191 1
China gtauts Coma. Gov't, 1911
d S C : IP &**• HaHan-t-'rn
rH
rH
IE
2 33
3 5«
5 1°
sets
5 18
6 o
16
16
ifi
16
16
.6
S
3
2
I
4 58
2 34
3 5«
S «
sets
5
6
2J
It takes two things to produce diphtheria — the diphtheria germ, and suscepti-
bility to the disease.
(25)
SOMEX>F< HUMANITY'S NEEDLESS BURDENS.
From an address by B. B. Ritienhouse.
With all its blessings modern civilization has introduced hazards,
habits and conditions of life which not only invite but which have in-
creased in many ways physical, mental and moral degeneracy.
Our birth rate is declining. Of over 20,000,000 school children
in this country, not less than 75 per cent need attention for physical
defects which are prejudicial to health.
The alcohol and drug habits are constantly adding to the degenerate
list and the death roll.
The diseases of vice are spreading and we lack the moral courage to
openly war against them.
Insanity and j idiocy are increasing at an alarming rate.
Suicides now reach the enormous total of 15,000 annually.
Attempts upon human life by individuals and mobs under trifling
provocation, or none at all, are obviously increasing.
Over 9,000 murders are committed every year in the United States.
Only about 116 murderers are executed for these crimes.
Our homicide rate is appalling — about 100 per million population,
against 13 in Canada, 9 in Great Britain, 15 in Italy.
The diseases of old age are reaching down into middle life and
below. Our vital organs are wearing out too soon.
We have had an increase of over 100 per cent in 30 years in the
death rate from diseases of the heart, blood vessels and kidneys, includ-
ing apoplexy.
These diseases claim over 350,000 Americans annually. Sixty per
cent of them are preventable or postponable if detected in time.
**********
Cancer destroys nearly 75,000 lives annually. The loss from exter-
nal cancer alone has increased 52 per cent in ten years.
Pellagra, a deadly plague, is increasing in the South, but it excites
little or no public concern.
Over 135,000 lives are taken by pneumonia, chiefly as a result of
weakened resistance from degenerative disease.
Over 150,000 die annually from the preventable plague, tuberculosis.
Nearly a million tubercular victims are constantly spreading the
malady to the well, with virtually no official supervision or restraint.
Over 25,000 are killed and 300,000 attacked annually by the prevent-
able filth disease, typhoid fever.
Other germ diseases carry off more people than tuberculosis and
typhoid fever. (Continued on page 27.)
MOON'S PHASES.
BOftTOM
HtW WwK
CWCMJD
D. K. 1«.
b. if, ifl.
9. H. H.
F.U'.
J i 34 A.
5 J 34 A.
5 034 A.
13 6 11 A
!4 O 31 A.
13 5 11 A.
HIM.
ax 1 ^M.ai 3 56 M.
31 1 56 M.
37 £ 41 A. 37 G 4.1 A.
*7 7 4* A
Historic*! Events:
I IS" I AUSahiW I***
LATITUDE
Of Barton 1 New
EngUnJ. N. Yin*
Sun, So. Mich.,
WLicoruln, lewv,
Wyo. And Oregon.
&un
rifle*
H II
Suo
Moon
LATITUDE
Of Ntw York City 1
PhdidtlV Conn..
Ncir Jcruy, Pa..
Otto, Indi»m. Ilil-
noU. Neb. And Cat.
Sun
rlaefl
SUD
It- f 3J 4 54 6 5 2 j ' 6 ll b 3°l4 57
Moan
6 59
44. 24th Sunday after Trinity. Matt, g I Oh. fSm. Bays Length. } Oh. 25 m.
2
3
3
■
4
In
5
\v
G
tu
7
Fr
8
Sa
<E gr, li oration W. o
<5TtC* Shanghai capt'd. 191 1
3t5#€
J?*. 9 gr heh lai. N,
ficuj. Harrison elected, 1&&B
Pcnucola taken. 1814
Gin Q: C in »P*ftw
«r
u 34
4 52
7 5 2 " 16
6 31
4 56
«r
& 35
4 5 2
8 58 Ji6
6 32
4 55
■a
6 36
4 5°
10 6 16
° 33
4 54
4X
O38
4 49
11 13 16
° 35
4 52
*X
*> 39
4 48
morn | 1 6
6 36
4 5i
A
6 40
4 47
o iS if.
& 37
4 50
A
6 42
4 46
i 20I16
6 38
4 49
7 59
9 4
10 1 1
11 17
mom
21
1 22
45. 25th Sunday after Trinity. John 3 10b. 2 m. Bay's Length. Wh. 9m.
9
S
10
M
1 1
T11
[2
vv
M
Th
«4
li-
>5
Sa
,E. W. Carmack died* 1968
Massacre at Nanking/ 1911
Gen. Wop I died. 1869
$ stiit n ■[j.'ii y
JJ/A* Sen. Clay d., 19m
La Seine ?.unk, 1909
(5^ C * N. M. Fiah died, 19ns
£
6 43
4 45
2 21
lb
6 39
4 4S
X
b 44
4 44
3 22
lb
641
4 47
**
b 45
4 42
4 24
lb
6 42
4 40
#p
b 47
4 41
5 zS'it6
6 43
4 45
#e
b 40
4 4°
6 34 i 16
6 44
4 44
S3
t> 49
4 40
rises iji6
6 45
4 43
Ft
b 5 t
4 39
5 25
15
6 4*>
4 43
2 21
3 2'
4 22
5 25
6 29
rises
5 32
#ff. 26th Sunday after Trinity. Matt. 8 9h. 46m Bay 's Length. 9h 54m.
16
S
<7
M
A
Tu
R)
W
20
Th
21
Fr
22
Sa
<J gr Jihratkm E. a
Raiph Johnstone killed, 1910
OJfl: fSWC
Tweed convicted. 1S73
««(. G.A-HdMrtd.1899.
< in fj. Tburlow Weed d„ i 891
6 16
7 '9
8 30
9 45
II I
mom
o 17
6 48
6 49
6 50
6 5"
° 53
6 54
6 55 !
42
41
40
40
39
38
6 23
7 26
8 36
9 50
II 4
morn
O 19
47- 27th Sunday after Trinity.
John 6 9h. 33m Dm- s Length. 9h. 41m.
n
s
24
2"
M
Tu
W
27
■8
Th
Fr
21)
Sa
(JQQ iiiicrmr
C in perigee
in peribcHon
•<S!d
27/A Thanksgiving Day
Joseph Parker died, inoa
Ohio admitted. 180s o
*
rH
1*1
» 3^
2 48
4 6
5 25
6 45
sets
5 35
sets
5 42
43. 1st Sunday in Advent.
Matt it
9h. 21 m. Bay's Length 9h. 31m.
30 |S | pltfl. St.Andrtw
j»|7 8|4 29 1 6 39||n||7 3J4 34 [ 6 46
It takes two things to produce smallpox— the smallpox virus, which no one has
but smallpox patients, and susceptibility to the disease, which everybody has ex-
cept the vaccinated.
(27)
Over 90,000 Americans are killed annually by accident and other
violence, and the loss is steadily increasing.
Over 1,500,000 people are constantly ill from preventable disease.
Over six million people will die from preventable cause during the
next ten years at the present loss rate.
The sum of $1,500, COO is a low estimate of the annual economic loss
from preventable deaths.
Our cities spent six and a half times as much to prevent fire- waste,
E: I though the money loss from life- waste is six times greater.
WHAT WE DON'T KNOW ABOUT PELLAGRA.
We don't know its cause, whether due to eating spoiled com, or
rancid fat, or something else —
Don't know whether it is transmitted by sandflies, by contact or some
other way —
Don't know whether it is a new disease in this country, or an old
one;
If we have it, don't know when we got it, or when we'll get well.
In fine, we don't know how to keep from getting it. or what to do\
for it when we do get it. - ^/
(fo
INFANTILE PARALYSIS.
Dr. M. J. Rosenau, of Harvard, has transmitted infantile paralysis
from monkey to monkey by means of the bite of the stable fly, the
Stomoxys calcitrans. He reported this at the XVth International Con-
gress of Hygiene and Demography but his report was received with
caution.
Since then, however, Dr. Anderson of the Public Health Service
has repeated his experiments with similar results.
There is, therefore, a strong inclination to think this is the way that
dread disease is transmitted.
The stable fly looks so much like the house fly that about the only
way an amateur can tell them apart is by the fact that the stable fly bites,
while the house fly does not.
"Tie a piece of lemon to your corn every night for five nights and
it will come off," says a "hint" in one of the papers. Yes, the lemon
will come off. — Pathfinder.
w'.u.
O- H. _
5 9 59 M.
1310 o M,
■D II 16 M.
i 7 9 M M.
D- II. U.
5 9 59 M
13 to oM
ao 11 16 M
»7 »»M.
5 i 5? H
3 Q p M.
ao 10 16 M
Historical Events.
LATITUDE
Of Bo*lon 1 Nnr
i EnifUnd. N. York
Sutc. So. Mich,,
WliC&nJin, low*
Wyo, and Oiigon.
LATITUDE
Of Ntw York CHyi
Philidtl'i, Conn..
Ntw Jtnty, p «-
Obis, Indiana, UU-
rwti. Neb. • nd Cal.
ftun dun
rtiie* Kta
!i M r{. U
Moon
McNamarx Bros.corjfes&ed. ig 1 1
(55 <I : ° siaiiotmry: d 9 9
Mary Baker Eddy died. 3910
H. O. Havemeyer died, 1907
3J7*. 5 gr. bet. lat. N.
CinapojEee. St J/tcAefaj
m
04 29
10 4 28
4 28
4 28
4 s8
4 28
7 49!|"
8 59, 11
10 5 10
ti 8
morn
o 10
4 4 34
5i4 34
6 4 33
7 4 j.;
«4 33
9 4 33
7 SS
9 4
10 8
11 10
morn
o II
49. 2d Sunday m Advent
Luic 31
9h. 13m. Day's Length. Sh. 23m.
1
S
8
M
9
Tu
IO
VV
it
Th
12
Fr
'3
Sa
8hS- T. B R«dd., 190a
King Oscar died, 1907
BritcTillc Aline Explosion, 1911
jj gi\ eJonp. W., ai°a'
Geo. Garcia died, 1898
6ha
131k. t gr. libr. E. a
**
7 15
4 28
1 11
8
7 10
4 33
s
7 16
4 28
2 12
8
7 *«
4 33
#1»
7 17
4 28
3 "5
8
7 12
4 33
<"F
7 I*
4 28
4 20
7
7 13
4 33
#f
7 19
4 28
5 27
7
7 >4
4 33
fr
7 20
4 28
6 37
b
7 »5
4 n
R
7 21
4 28
rises
6
7 16
* 33
I II
2 IO
SO. 3d Sunday in Advent.
Matt, tt
Sh. 7m. Day s Length. Sh. 18m.
14
S
'1
M
16
Tu
:i
VV
Th
ig
F*
20
Sa
Geo. Washington died, 1799
(jeffl. R. L. Gibson d„ iSga
(SW C Gen. Terry died, 1890
King Leopold LI. died, 1909
XI It. Amendm't ratified, 1B65
CtftBU
JO/A. Valid died. tj$7
21
22
23
>3
24
25
26
4 28
4 29
4 29
4 29
4 29
4 30
4 3°
21
7 36
»S2
10 7
ii 22
morn
4 34
4 34
4 34
4 34
4 35
4 35
4 3 6
6 27
7 4i
8 56
10 10
11 23
mora
St. 4th Sunday in Advent.
Jokn t
Bh. 5m. Dav's Length. 9h. 1 5m.
21
S
22
M
*3
Tu
24
VV
25
Th
2f>
Kr
27
Sa
4 In perigee, St* Thauttts
emtrrs Ifr* Winter fagiur
Battleship Utah launched, aoog
Clarence King died, 1901
Ckri xtmai De&
A5 4- Si.Sttphe* «
J7*A. jy. fahr. Evang.
fr
7 26
4 3'
37
2
7 21
4 36
fr
7 26
4 3'
1 52
1
7 21
4 37
A
7 27
4 32
3 7
1
7 22
4 37
A
7 27
* 12
4 24
7 22
4 38
*
7 28
4 33
5 4"
si.
7 22
4 38
*
7 28
4 34
53
I
7 23
4 39
*
7 29
4 34
sels
1
7 2}
4 40
36
1 s°
3 4
4 19
5 35
6 46
set's
52. tat Sunday after Christmas. Matt, i 9h. 6m. Day's Length 9h. 17m.
28
29
30
31
S
M
Tu
W
<J14fl. Anxemtt
Iroquois Theatre Fire, 1003
OinO.
a.
7 29
7 29
7 29
7 30
4 35
4 36
4 3°
4 37
s 29
6 39
7 48
8 54
* II 7 23
2 ■! 7 24
3 7 24
3 7 2.)
4 40
4 4 1
4 42
4 42
5 35
6 44
7 52
8 57
The diseases that have to be controlled by quarantine are never controlled.
(29)
SOME TESTED TRUTHS OF PUBLIC HEALTH.
It is better to sleep in a cold room than in a cold grave.
Clean water, clean food, clean air, clean hands : these are the gems
of health.
Keep your germs to yourself ; make your neighbor keep his.
Many an undertaker would go bankrupt if people were as careful
of their health as they are of their money.
A trash-proof well and a fly-proof privy help to make a disease-
proof family,
A filling in time saves a tooth — and a digestion.
The healthy mother who nurses her child gives it a heritage of
health more precious than four per cents.
Fresh air is cheaper than drugs, better than doctors and always on
call.
A syringe of antitoxin to prevent diphtheria costs fifty cents; a
funeral is cheap at two hundred dollars.
A sanitary school is as essential to a child's health as is a good
mother.
Many people would blush to keep their kitchens as filthy as they
keep their mouths.
Twenty dollars spent in improving the sanitation of a country school
may mean more to the pupils than five years' instruction.
Good teeth are necessary to good digestion. Save your teeth and
you save your stomach.
Labor spent in ventilating rooms is labor saved in digging graves.
If the people of Virginia would contribute to public health what
they spend on medicine, they could save their doctors' and undertakers*
bills. — Virginia Health Almanac.
THE FEEDING OF INFANTS AND CHILDREN.
If the mother be healthy, the infant's sole nourishment for the first
eight or nine months of its life should be the mother's milk, which forms
the only perfect food for the child at this time.
For the first six weeks of its life the infant should receive nourish-
ment every second hour from 5 a. m. to 11 p. m., and should be removed
from the breast whenever it shows any inclination to stop sucking.
During the second month feeding every three hours is generally
sufficient, and from this time up till eight months, the intervals should
be three to four hours.
(30)
After the eighth or ninth month other foods may be introduced at
some of the feedings, and between the tenth and twelfth months the
child should be gradually weaned.
Should the mother be unable to suckle the child, a young and healthy
wet-nurse may be obtained, or the infant may be reared on substitute
foods.
If it be decided to employ artificial foods, the milk of the cow, ass
and goat, and condensed milk have been proposed as substitutes for that
of the mother,, whilst many prepared foods for infants are supplied.
These usually contain starchy matter in a readily assimilable form, as
well as some malt preparation.
"The so-called 'infants' foods' usually contain some malted farina-
ceous substance, and they are of value as additions to, not as substitutes
for milk." Ordinary farinaceous foods, such as arrowroot, are never
admissible before the fourth month, and rarely advisable until after the
seventh.
Cow's milk is generally selected as a substitute for the mother's.
The following table shows their average composition :
Human Milk. Cow's Milk.
Water 87.163 87.012
Fat 4-283 4.209
Casein 1.046 3.322
Milk-sugar 7.407 5.000
Ash , .101 .527
Not only does cow's milk differ in chemical composition from that
of the mother, but it is distinguished also by its physical properties.
Cow's milk, therefore, must be modified in order to make it a fit sub-
stitute for human milk.
Human milk is poorer in casein, but contains more lact-albumin. By
diluting cow's milk with water the proportion of casein can be reduced
to its proper level, whilst the addition of cream and milk-sugar
(lactose) gives the cow's milk its proper amount of fat and sugar. The
water for dilution should be boiled, and it is still better to use very thin
barley water or decoction of arrowroot (one fluid drachm to one pint) ;
this prevents the curds formed from being too large.
It is preferable to sterilize the milk itself. This is best done in
proper milk sterilizer ; failing which, heating the milk to the boiling
point and then cooling rapidly is the method employed.
Pasteurization of milk consists in keeping it for at least twenty
minutes at a temperature of 150-160 degrees Fahrenheit (60-65.6
degrees C). This process is found to destroy pathogenic microbes,
(31)
and it is claimed that the natural taste and quality of the milk are
retained.
Some authorities state that cow's milk, efficiently sterilized, is best
given undiluted, as hard curds are not formed in the stomach, and the
infants gain weight more rapidly on undiluted than on diluted milk.
Dilution: This is the general practice. Provided the milk has not
been previously watered, the proportion for infants at various ages
may be taken as follows :
Age of child.
Up to 1 month
From 1 to 3 months
From 3 to 4 months
From 4 to 5 months
Proportions of
Milk. Water.
1 2
1 1
1 %
i y&
From the fifth or sixth month onward the milk may be given un-
diluted.
Sugar: Add 60 grains, preferably milk-sugar (lactose), to every
four fluid ounces of diluted milk.
Fat : Add one dessertspoonful of cream to every four fluid ounces
of diluted milk.
The amount of cow's milk to be given, and other particulars, are
summarized in the following table:
Age.
Number
of feed-
ings in
twenty-
four
hours.
Interval
between
meals by
day.
/io n ™ for one
(10 P- m- fee(Ji
7 a.
m.
m.)
Quantity
for
twenty-
four
hours.
3d to 7th day
2d to 3d weeks
4th to 5th weeks
Gth week to 3d month.
3d to 5th month
5th to 9th month
9th to 12th month.....
10
10
9
8
7
6
Hours,
2
2
2^
214
3
3
3M
Fluid-
Fluid-
ounces.
ounces.
1-1J4
10-15
1J4-3
15-30
2J4-3>4
22-32
%-A%
34-36
4-5J-S
28-38
5^-7
33-42
7^-9
37-45
—Infant Feeding.
@!®@®®@@@&@@®®@&®@&@@&@gl@®®
IF
(From Rewards and Fairies by Rudyard Kipling.)
If you can keep your head when all about you
Are losing their* and blaming It on you;
££ If you can trust yourself when all men doubt you,
bd But make allowance for their doubting too;
bd If you can wait and not be tired by waiting,
bd Or being lied about don't deal In lies,
™ Or being hated don't give way to hating,
*£( And yet don't look too good, nor talk ten wise;
29 If you can dream — and not make dreams your master:
If you can think — and not make thoughts your aim;
If you can meet with Triumph and Disaster
And treat those two impostors just the same;
If you can bear to hear the truth you've spoken
Twisted by knaves to make a trap for foots,
Or watch the things you gave your life to, broken,
££ And stoop and build them up with worn-out tools;
■
{§J If you can make one heap of all your winnings
(§ And risk it on one turn of pitch-and-toss.
And lose, and start again at your beginnings,
And never breathe a word about your loss;
29 If you can force your heart and nerve and sinew
To serve your turn long after they are gone,
(S And so hold on when there Is nothing in you
Except the Will which says to them: "Hold on!"
■
jCf If you can talk with crowds and keep your virtue,
XX Or walk with Kings — nor lose the common touch;
?gj If neither foes nor loving friends can hurt you;
[Cj If all men count with you, but none too much;
Kj If you can fill the unforgiving minute
TBI With sixty seconds' worth of distance run,
net Yours Is the Earth and everything that's In it,
Jffj And — which is more — you'll be a Man, my son!
m
®
!@&@i£}§&@&&®8§;&®@gc&&®&&&®
^Y,0Rl£> 4
Health HSSNotes
OFFICIAL BULLETIN
Published Monthly by the
STATE BOARD OF HEALTH
Subscription 50 Cents per Annum
Entered as Second Class Matter, April 20, 1910,
At the Postoffige at St. Augustine, Florida, Under the Act of July 18, 18M.
Vol. VIII February, 1913 No. 2 (j£&)
Hon. E. M. Hendry, President, Hon. H. L,. Simpson, M. D„
Tampa, Fla. Hon. John G. Christopher, PensacoJa, Fla.
Jacksonville, Fla.
edited by
Joseph Y, Porter, M. D., Secretary and State Health Officer.
Hiram Byrd, M. D., Assistant State Health Officer.
EXECUTIVE OFFICE AND CENTRAL LABORATORY:
State Board of Health Building,
Springfield Boulevard,
Jacksonville.
BRANCH LABORATORY U
State Board of Health Building
Florida Avenue and Constant Street, Tampa.
City Hall, Pens a col a.
Sent to any address in the State for the asking.
If you receive it without asking, it means that someone else has requested
it for you.
When you change your address drop us a card.
When giving change of address, give both the old and the new.
Anything you want to know about the public health we will try to tell you.
Any information you want about communicable diseases of domestic animals
we will help you to get.
Address communications to Jacksonville, Fla.
Da men gather grapes af thorns? or figs of thistles' — Mat. 7:16.
(3*)
THE BREAKING OF DAWN
That progressive paper, The Pensacola Journal, which generally
gets what it goes after, is impatient over the "wishy-washy" policy of
continental America in dealing with the smallpox question. Read what
Frank Mayes has to say about vaccination, and then you cute "fellers"
of the press who delight to he known as "antis" and are stubbornly
prejudiced, "sit up and take notice" :
SANITARY SCIENCE IN THE PHILIPPINES AND HERE.
(Pensacola Journal, Feb. 9, 1913.)
Hearst's Magazine contains the following interesting facts concern-
ing the elimination of smallpox in the Philippines :
In the annual report for 1911 of the board of health for the Philip-
pine Islands Dr. Carol Fox gives some interesting statistics showing
the effects of sanitation. It is noted, for example, that more than ten
million people have been vaccinated in the Philippines without a single
death occurring. Thus smallpox, which had been prevalent since the
occupancy of the islands by the Spaniards, has practically ceased to
exist.
It is difficult to pass by this particular item without a word of com-
ment that has general application.
Vaccination for smallpox, as everybody knows, was introduced by
Jenner more than a hundred years ago. At the time when the method
was introduced smallpox was an epidemic disease that claimed. about
one-tenth of the total population of Europe by death. Its familiar
marks were upon the visages of a majority of the remainder.
Soon after the introduction of vaccination the prediction was
freely made that smallpox would be altogether eliminated from the
world within a few decades. The prediction was so nearly fulfilled
that smallpox became a rare disease. But just because vaccination
had so nearly eliminated the malady, the malady itself was no longer
feared, and the manner of its subjugation was in many quarters all
but forgotten.
Instead of taking the relatively simple steps that would be required
to complete the elimination of smallpox, the general public became
indifferent to the disease, and in some quarters, by a curious paradox,
societies were formed to antagonize the practice of vaccination. So a
few residual cases of smallpox have been allowed to exist and transmit
the germs of the disease generation after generation. That such is the
case is a reproach to human intelligence ; but the fact being as stated,
it is worth while to lay special emphasis on the new object lesson in
the preventability of smallpox that the recent experience in the Philip-
pines has given.
The foregoing, when considered in connection with the fact that
smallpox has never been eliminated in the United States, affords a fine
object lesson of the difference between the compulsory application of
sanitary science, as it exists in the Philippines, and the voluntary
(35)
application of the same smallpox preventive in the United States.
In the Philippines vaccination is compulsory. Result — smallpox is
now unknown. The same condition exists in Germany.
In the United States we leave such things to the voluntary will of
our people. Result- — -smallpox we always have with us.
Personal liberty under this great American government is a fine
sounding term, but in practice it frequently results in danger to the
health and lives of the whole public.
HOOKWORM INFECTION THROUGH SKIN
Dr. Bailey K. Ashford, who was appointed a member of the Porto
Rico Anemia Commission, and who found that that disease was due
to the American hookworm, as far back as 1899, and who had been
treating the disease and relieved thousands of sufferers two years
before Stiles' first bulletin on Hookworm Disease was published, and
who up to the present time has treated no fewer than three hundred
thousand cases, takes little stock in hookworm infection except through
the skin.
The State law, which provides for screening dining-rooms and
kitchens and "passage ways leading thereto" is inoperative if the
screen doors are kept wide open. Simply hanging the doors or putting
in the window screens is not altogether complying with the law. There
was a definite purpose to be accomplished when the senator introduced
and passed that bill in the legislature of 1911, and that was to keep
out flies : keep out flies which might be contaminated from distributing
typhoid germs to the food.
The House of Commons has a Select Committee that is now in-
quiring into the patent medicine sales, advertising, purity, and other
features. The Home Secretary, on the witness stand, stated that it
had been the view of the Home Office that the advertisement and
extensive sale of proprietary medicines was a mischief, but that it was
an evil that must be met rather by the spread of education than by
legislation.
That is worth saying again, for it doesn't apply only to proprietary
medicines, but to vaccination, for example. It doesn't apply only in
England, but equally in Florida. And that is the position of the State
Board of Health in regard to vaccination. While the Board knows
the value of vaccination in preventing smallpox, it also knows that
there are many people who prefer to take their chances with smallpox.
C36)
These the Board will protect as far as possible, But it must warn
them that it can not give as complete protection as they desire, and
that from time to time some of them will get caught.
A man wrote from Illinois and inquired about the laws governing
bringing his cattle with him. He is going to move to Florida. We
had to tell him that if he brought his cattle they would die of tick fever.
It wasj the truth and we had to tell it. Don't know whether he will
come now himself or not. There are a lot of other people to come,
top. They have got to sell their tick-free cattle up there and get ticky
cattle after they get here. In other words, they have got to sell their
well cattle and get sick cattle.
NOTICE
Parcel post stamps are good only on matter that has heretofore
been mailed as fourth class. In sending specimens to the laboratory,
or in sending any matter to the State Board of Health, it will save
delay and misunderstanding if all articles are properly posted. In the
first place, when parcel post stamps are attached to articles that it is
not supposed to carry, it is the postmaster's duty to hold the article in
question for postage, which causes no inconsiderable delay and in-
convenience. Remember that parcel post stamps are to be used only
on fourth class matter.
FEAR VERSUS REASON
In the days of long ago, the golden days of childhood, when writ-
ing was taught not by the Spencerian method, but by the school
mistress setting copies for the students to follow, and when each page
of the copy book commenced with a letter of the alphabet, there was a
sentence beginning with the letter "F" which read : "Fear is more
powerful than reason," which impressed the writer very much at the
time. As a child I could not understand its meaning. As a youth I
resented the thought, but now as the shadows are lengthening over
the pathway of life and the end of the road may be dimly seen, with
the milestones traveled lessening in the distance passed, I am forced
to admit that fear is more powerful than reason, and that mankind
in general is governed by, and stands in greater dread of supposed
danger than there is a willingness to acknowledge or of which to
calmly argue out the probability. While we pride ourselves upon our
(37)
advanced civilization and boast perhaps not without just cause of the
progress made in the sciences, and have ground to be proud of the
achievement of both, yet if we stop to think a bit we must admit that
there is still a mysticism of the savage in our nature and a spirit of
superstition in which fear is a potent factor whispering of apprehension
of danger to come, rather than giving ear to sound argument or intel-
ligent judgment. To follow is easier than it is to lead. The soldier
in the ranks has a simpler task to fulfill than the general who directs
and initiates an attack, and the sanitarian who sits steady in the boat
and does not chase will o' wisps of improbable uncertainties is certain
to command more respect from the people than his visionary or the-
oretical brother. It is so easy to drift with the tide. The craft will
float along with its own weight and with no exertion or propelling
force from within if in the tideway. So, too, is it an easy matter to
follow in the wake of popular clamor against this or that supposititious
menace to public health and to advocate this or that idea of progressive
—so called — sanitation based altogether on theory and not on prac-
tical experience, and without carefully sifting all facts or balancing the
results gained from cautious observation. It is not sound wisdom to
recommend anything either to protect life or preserve health on specu-
lative theory or supposed possibility. When a deviation is made from
known and well proven facts to the realms of possibility and not
probability, then it is that the sanitarian is getting into deep water and
the element of fear dislodges reason and is given a greater force or
motive for action than would have been the case had calm and deliberate
j udgment, based upon reason, been given the preference either in argu-
ment or recommendation. Sooner or later a reversal of judgment
follows, and the public then begins to doubt whether we really know
what we are talking about. Sensational advice in a would-be guarding
of the public health, and a play to the galleries for popular approval on
the ground of progressive sanitation, is really a hindrance to the
advance of preventive medicine, and sooner or later reacts and brings
discredit on the individual or board who recommends it.
TWO COMMON FALLACIES
Some people, supposedly knowingly to themselves, but without
adequate information of facts, speak of this or that ailment with the
assurance of one well versed in the subject. For instance, we often
hear a person say, "I'm bilious," with no fixed idea in mind o£ what
he or she is saying. When asked what is meant, whether too much or
(38)
too little bile is wandering around in the system or circulation, no
intelligent answer is given; in fact, more frequentiy than otherwise,
the reply is, "I don't know, but feel badly. My tongue is coated,
appetite lost and sleepy all the time," or some chain of symptoms is
described. These people are an easy prey to the patent medicine seller,
and fall into his clutches with amazing pliancy. The liver and its
accessories is a much abused organ, abused in the sense that it is mis-
treated from over-eating and gormandizing, and abused through
ignorance of its function. A little insight on the physiological
processes of various organs of our body should save not only our
health from pernicious doctoring, but our pockets from useless expen-
diture.
There is another common error into which many people fall, and
upon which the patent medicine people fatten, and that is "kidney
trouble." There is scarcely a day which passes but one does not hear it
said : "I know that I have kidney trouble because my back aches so."
Now is it true that a pain in the back indicates a diseased condition
of the kidney ? Is it not true, according to physiological anatomy that
the kidney is but sparingly supplied with sensitive nerves, and that
unless there is a destructive inflammation of the organ resulting in
abscess and pus formation that pain as a distinct symptom or indica-
tion is lacking? Is it not true, also, that it is only through chemical
and microscopical examination of the excretion of the kidney that a
diseased condition of the working parts of the kidney is found out ?
Now if that is so, and it is so, what has a pain in the back, which
doubtless is purely muscular, to do with the kidney? The sad part of
all this is the outcome of a self-constituted knowledge of the functions
of the kidney. A speedy visit to the nearest drug store, either of one's
own volition or most probably on the advice of a friend, to purchase
something "good for kidney trouble." Here is found no end of patent
medicines good for anything, and everything, according to printed
wrappers bearing testimonials from the so-called "distinguished
citizens," and especially for "kidney trouble"; and the sufferer from a
muscular backache deluded with the idea of having a serious kidney
trouble, easily falls a victim to charlatans and quack medicine vendors
by purchasing a compound of which he knows nothing, and of which
the druggist can give no information.
Alabama has 160,000 acres tick free pasture land. They just went
after it and cleared it.
#. (39)
A NEW USE FOR GERMS
There may be good trusts and bad. There certainly are good germs
and bad. We all agree that the diphtheria bacillus when it causes
diphtheria is a bad germ. It is also held that when it inhabits a well
throat and refuses to be dislodged, it is liable to cause the spread of
diphtheria by getting a few germs loose here and there and these
finding their way into other throats and setting up trouble. These
carrier cases of diphtheria are a problem. For, after a case of
diphtheria gets well, it is frequently a great proposition to get the
individual rid of the germs. They defy our efforts to dislodge them.
Quite recently other germs have been called into service to get rid
of the diphtheria germs. When a carrier case still persists in carrying,
his throat is sprayed with a culture of the staphylococcus pyogenes
aureus (Whew!), and that is said to get rid of the diphtheria germs.
Dr. Raven el of Wisconsin reported at the American Public Health
Association excellent results, and his experience seems to be pretty
generally confirmed by others who have tried it.
WHAT TO DO IN CASE OF SMALLPOX
First of all report it to the State Board of Health. If uncertain as
to whether it is smallpox, report it just the same, and let the Board
send an 'expert to settle the matter.
The care of the case should then be given over to some one who has
had smallpox or who has been vaccinated. All persons exposed or likely
to be exposed should be promptly vaccinated, and after vaccination
takes any of them can see the case with perfect safety — just as the
physician himself can see it with safety.
If you are afraid to get vaccinated, or for any other reason fail to
do it, and get smallpox, the Board will take the best care of you it can.
It will furnish you plain food, provided you are indigent. It will give
you medical attention provided you ask for it, but it is against the law
to thrust medical attention upon you. It will keep you shut up in your
own house, provided you have one, or if you are in reach of a pest
house it may send you to that. It wilt also pacify the neighbors the
best it can, and endeavor to keep them from doing you violence. All
this will the Board do when you get smallpox. Or, if you prefer, it
will keep you from having smallpox, without danger and without cost,
just as the physicians themselves keep from getting it — this if you
choose.
i
,
(42)
EMERGENCY SUPPLIES FOR THE HOME
In every household, even in the middle of a city with drug stores
near by, it is wise to have a few simple remedies and surgical dressings
on hand. This is more especially the case if there are children in the
household, as little people are so likely to hurt themselves and are
much more liable to sudden illness than are grown-ups.
Neat emergency cases which fill all requirements fairly well may be
purchased. Being especially made for the purpose, they possess the
advantage of having a place for everything and everything in its place.
They are rather expensive, however, and there is no reason, if you
care to take the trouble, why you can not buy your own box and fill it
to suit your own particular requirements. The standard size for your
bottles of liquid medicines had best be two ounces, and the square
bottles should be used. The box should be just high enough to take a
two-ounce bottle corked, standing up, and big enough for all the
supplies you need. Medicines prescribed by a doctor in illness are
much better put in a safe place where they will not be meddled with,
so it will be wise to leave space for them in your box. This may be
made of metal or hard wood and should, preferably, have a key.
The supplies suggested for the ordinary first aid household box are
as follows:
Alcohol.
Aromatic spirits of ammonia ( rubber cork) ,
Castor oil.
Epsom salts (or y 2 dozen Seidlitz powders),
Lime water.
Mustard (powdered).
Sodium bicarbonate.
Syrup of ginger.
Syrup of ipecac.
Witch hazel.
One-tenth grain calomel tablets (small bottle, 50-100 tablets).
Five-grain Bismuth subnitrate tablets (100).
Carbolized vaseline (1 glass jar).
1 drachm bottle oil of cloves (labeled "Poison").
1 bottle 50 soda mint tablets.
1 tin talcum powder.
1 small package antiseptic gauze.
J4 pound absorbent cotton.
6 gauze roller bandages (3 large and 3 small).
% U. S. army First Aid dressings.
1 roll oiled silk.
1 roll old muslin.
1 small bottle collodion, with brush.
(43)
1 box tooth plasters.
1 box tooth wax.
1 box corn plasters.
1 sharp knife.
1 pair scissors.
Pins (ordinary and safety).
It is particularly gratifying to note that the death rate in general
for the city of Jacksonville has been decreased during the past year
from 21 per cent to 18 per cent. (Resident death rate 14 per cent, 1912.)
It is gratifying because it shows what a systematic and aggressive
policy will accomplish when backed by knowledge of how to do things,
and Dr. Terry, Jacksonville's city health officer, is deserving of great
praise for accomplishing so much.
THE REFERENDUM AND TUBERCULOUS DAIRY HERDS
Los Angeles undertook to get rid of tuberculosis among the dairy
herds. An ordinance was accordingly passed and referred to the people
who defeated it. So Los Angeles will continue to have tuberculous
dairy herds.
THE MEDICINE MAN AND TICK ERADICATION
By C. R Dawson, M. D., D. V. S.,
Veterinarian, State Board of Health.
The present agitation for the eradication of the cattle tick has a
special significance to the medical profession. Not only does the cow
tick convey a blood parasite to the cattle it bites, but this parasite has
some points in similarity to the malarial organism in man, in that it is
carried by an insect, and that it lives in the red blood-corpuscles,
destroying these, reducing, in some cases, the corpuscle count to
1,500,000.
Of special interest are the facts that this intra-corpuscular parasite,
the Pyrosoma bigcminum, was discovered by a medical man, Theobald
Smith, M. D. The life history of the cattle tick, its host, was dis-
covered by a medical man, and the idea of tick eradication was first
introduced by the same medical man, Cooper Curtice, M. D. It is,
therefore, to these three discoveries that the final riddance from the
cattle industry of the formidable disease produced by this parasite
will be due.
One of the chief glories to be added to those already enumerated
(44)
is the fact that the discovery by Dr. Theobald Smith that this Pyrosoma
bigeminum, carried by the cattle tick, the cause of Texas cattle fever,
or southern cattle fever, or cattle malaria, was the first instance in the
history of medicine where it was proven by scientific investigation that
a disease can be insect-borne. This was truly an epoch in medical
history.
It is also of special interest that the cow tick can be eradicated. It
is being eradicated. No other disease -producing insects can be
eradicated. They can only be controlled.
Digressing, what a boon to humanity, could mosquitoes and hook-
worms be eradicated. Malaria, yellow fever and uncinariasis would
cease for want of carriers, and a cause.
Finally, it appears to the writer that the eradication of the hook-
worm, which is sapping the vitality and manhood of millions, is not
only not an impossibility, but that it could be carried out as successfully
as is tick eradication.
In the good old State of North Carolina, and in the county of Bun-
combe, famous for an Asheville, .there has arisen some sharp criticisms
of the State Board of Health. The best we can make it out, the cause
of the controversy is that some people don't want anybody to have small-
pox, and some people insist on having it; and that started the row.
As for our part, we look upon good health and religion somewhat
in the same light — if you have to hold a man to baptize him it's not apt
to take, and you don't help the cause of religion very much.
There is no better way of knowing a man then by comparing his
front with his back yard. One who cleans up the part that shows and
leaves dirty the part that doesn't show— the less dealings you have with
him the better.
A large number of people seem to think that bad smells are indica-
tive of disease producing causes. No one disputes that decaying matter,
whether vegetable or animal, is discomforting to the nostrils as well as
offensive and disgusting to sight; yet the clearest sparkling water
from a pretty gurgling brook may hold millions of death dealing germs,
and so, too, the brightest in nature's garden of flowers in delicate odor
and perfume often causes physical discomfort and suffering in rose
fever and nostril irritation to those peculiarly susceptible to the pollen
of plants.
(45)
FOR PREVENTION OF MALARIA
Malaria is a mosquito-bo roe disease— that way and no other.
It follows then that those who protect themselves against the bites
of mosquitoes escape malaria.
"But," you will say, "it is impossible to protect oneself against
mosquitoes, at all times, and in all places/'
And this is true. It is impossible. But the mosquitoes that transmit
malaria bite only in the night. If, therefore, you protect yourself
against mosquitoes during the night, you will not be bitten by malaria
carriers and will not have malaria.
This amounts to saying that if you will sleep only in screened
houses, or under mosquito nets, you will be safe against this disease.
It is fully recognized that there is a margin of error in this, for
sometimes mosquitoes get into houses that are screened, and some-
times they get into mosquito nets, and sometimes people get bitten
before going to bed when up late at night — all of which has to be
reckoned with. But he who earnestly tries to escape malaria is
infinitely safer than he who doesn't.
In addition to this there is something else that may be done. It is
to be remembered that no mosquito can transmit malaria till after
he has bitten some one who has the disease. Therefore, if all persons
who have malaria were kept under mosquito nets, so as not to infect
the mosquitoes, this would go a long way to protect others against the
disease.
There is one other thing; this is for the doctor. During the first
two weeks, or thereabouts, that a person has malaria, he can't infect
mosquitoes. Therefore, if all cases are treated rigorously, so as to
get well in two weeks or less, they will not infect mosquitoes, and there-
by other people.
Now just one other thing about malaria: After one has it, and
treats it slowly, and gently, like he was afraid to get rid of it, he be-
comes a chronic malaria carrier. That is to say, he gets well, or thinks
he is, but still has some of the malarial parasites in his blood. Such a
person is capable of infecting mosquitoes, and should religiously sleep
under mosquito nets till free from parasites — this in the interest of
others — and then he should continue to do so to keep from getting
reinfected, this in the interest of himself.
But there are so many voluntary precautions in this that each bad
better take all the precautions he can.
(46)
Children should have plenty of fresh air, good food, exercise, rest
and sleep. They should sleep in bedrooms with the windows open
both summer and winter, and no child under twelve years of age
should have less than nine hours of sound, refreshing sleep. Children
should be taught to be regular in their habits of eating, sleeping and
exercise. They should also be taught habits of personal neatness and
cleanliness. Unless carefully watched they will not wash their faces,
comb their hair or brush their teeth — Press Service, North Carolina
State Board of Health.
From the hookworm eradication bureau of the Rockefeller Sanitary
Commission of North Carolina, the following news notice is sent out :
The campaign of the hookworm eradication is making the most
rapid strides in the history of the campaign. Seventy-one counties in
the State have now made the local appropriation necessary to have six
weeks devoted to a campaign of free examination and free treatment.
The counties providing for the campaigns last Monday are Currituck,
Pasquotank, Perquimans, and Mecklenburg. Hyde county is now the
only one east of Raleigh which has not yet made provision to have the
free treatment. The local appropriation is used solely for paying the
local expenses of advertising, traveling expenses of a laboratory man,
and the cost of thymol and specimen containers given out in the county.
During 1912 135,872 persons were microscopically examined for
hookworm infection or about 450 persons for each week day of the
year. For each dispensary day in January an average of 525 persons
"were examined and of these an average of 110 persons were found
infected and given free treatment. The campaigns are conducted in
six counties at the same time. The work is now in progress in Dare,
Tyrrell, Camden, Pamlico, Moore and Union counties. Five counties
— Wilson, New Hanover, Wake, Craven and Beaufort — have asked
for a second round of dispensary work for the benefit of those who
were skeptical when the first campaign was conducted, but have now
seen the results of the cures in those who took the treatment and are
desirous to again have dispensaries within their reach.
During the course of the outbreaks in both Los Angeles and Buffalo
there was an effort on the part of certain residents to belittle the im-
portance of the epidemics and the active measures being taken by the
health departments, with especial reference to the publicity being
given regarding the presence of the disease and the number of cases
occurring. However, in neither case did this prove a material embar-
rassment to the health authorities, who received the earnest support of
both the practicing physicians and the citizens in general.
The impression that publicity regarding such matters injures
(47)
municipal interests is based on a fallacy. The existence of an epidemic
can not be concealed very long, and the absence of frankness in regard
to the situation under these conditions produces a fear and suspicion
that it takes some time to overcome.
There is nothing that inspires so much confidence in the ability of a
community to cope with a sanitary problem as frankness and honesty
at all times in stating existing conditions. It shows that the com-
munity has the situation in hand and that it has sufficient conBdence
not to be afraid to inform others as to what is going on. The ethics
of concealment of epidemic conditions is of course indefensible. — From
Public Health Reports.
TYPHOID IN WASHINGTON
The Washington Post explains that the prevalence of typhoid fever
in Washington is due to the fact that during the Civil War the site
now occupied by the Union Station was an old hospital camp and that
the ground became saturated with typhoid; that now whenever that
ground is disturbed, typhoid is to be expected; that recent excavations
looking to terminal improvements resulted in an exacerbation of
typhoid fever, and that the only way to escape it is to leave it undis-
turbed and that in the course of time it will die out.
That explanation has a familiar ring. It takes the doctor back to
the days of venesection and laudable pus ; it takes the traveler back
to the stage coach : the housewife back to the spinning wheel, and the
tallow dip. One can almost see the old dirt oven and smell the delicious
fragrance of the ash cake crust, while listening to the voice of this
Rip Van Winkle calling from the past.
THE WORST YET
The doctors gave Mr. Roosevelt tetanus antitoxin. That was not
because he had lockjaw, understand — his bitterest enemy wouldn't
accuse him of that— but to keep him from having it. The worst thing
Mark Twain could think of was to have rheumatism and St. Vitus
dance at the same time, but what about lockjaw in a political campaign?
SEVEN-DAY FEVER
Dr. J. C. Perry, of the Public Health Service, reports "seven-day"
fever in Panama. If he hadn't told us it wasn't, we would 've thought
it was dengue.
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"Frenzied Sanitation" is a species of mania which affects those
engaged in health work and impels them to do impracticable things and
give impracticable and senseless advice in the name of the Goddess
Hygiea. For instance, quarantining pellagra, anterior poliomyelitis,
and leprosy, with armed guards.
"Frenzied Finance" is destructive to business life and commercial
advance. So likewise is "Frenzied Sanitation" a mischievous proceed-
ing and ruinous to the cause of preventive medicine.
DON'T BE AN EASY MARK
Why do you have a spleen? No one knows. The best learned
scientists of the world have come and gone, and still the riddle of the
spleen remains unsolved. Some have thought that its function was
this, and others that it was something else, and so on. In a few cases
of surgical operations it has been necessary to remove a part or all of
the spleen and the patient lived and nothing happened. Hence why is
a spleen ?
Whether or not we find a use for the spleen this point should be
remembered. If the world's greatest scientists can't tell the use of the
spleen, and if we get along about as well without it as with it, why do
people break their necks buying "electric belts" or "magnetic pads,"
plasters, insoles, etc., for what the street fakers and medical fakers
call "enlarged spleen," "torpid liver," "kidney disease," and a dozen
and one other things that no one ever knew he had before? Such
swindles belong to the "gold brick" class. When such ads of fakers
appear it is a good time to keep your money in your pocket and "save
your face." Take it from me, if you bite you lose, and the other fellow
will set you down as one of the original easy marks. — Press Service,
North Carolina State Board of Health.
MR. WILLIAM KOPMAN HYER
It is with a feeling of deepest regret that we note the death of
Mr. William Kopman Hyer, of" Pensacola, Fla., on February 16, 1913,
at the age of 76 years. Mr. Hyer was a member of the first State
Board of Health of Florida, having been appointed by Governor
Flemming in 1889, and in later years served as its agent in Pensacola.
He was a man of broad views, living a truly Christian Hfe, and ever
mindful of the comfort and welfare of those around him.
^ORIO^
Health wISNotes
OFFICIAL BULLETIN
Published Monthly by the
STATE BOARD OF HEALTH
Subscription 50 Cents per Annum
Entered as Second Class Matter, Aran, 20, 1910,
At the Postoffice at St. Augustine, Florida, Under the Act of July 10, 1894.
Vol. VIII March, 1913 No. 3 (JK.)
Hon. E. M. Hendry, President, Hon. H. L. Simfson, M. D.,
Tampa, Fla. Hon. John G. Christopher, Pensacola, Fla.
Jacksonville, Fla.
EDITED BY
Joseph Y. Pouter, M, D., Secretary and State Health Officer.
Hiram Byrd, M. D., Assistant State Health Officer.
executive office and central laboratory:
State Board of Health Building,
Springfield Boulevard,
Jacksonville.
branch laboratories :
State Board of Health Building
Florida Avenue and Constant Street, Tampa.
City Hall, Pensacola.
Sent to any address in the State for the asking.
If you receive it without asking, it means that someone else has requested
it for you.
When you change your address drop us a card.
When giving change of address, give both the old and the new.
Anything you want to know about the public health we will try to tell you.
Any information you want about communicable diseases of domestic animals
we will help you to get.
Address communications to Jacksonville, Fla.
After all, there is no aristocracy that is higher than the aristocracy of the
daily bath.— Kipling.
THE PREVENTION OF MALARIA.
The preservation of health is the first law of nature and it is safe
to say th.-tt none of us will deliberately do anything knowingly when by
so doing we invite departure from good health. A hundred, fifty, yea
ten years ago, we were all doing various things prejudicial to good
health that none of lis would dream of doing today. The life span of
the human race has undoubtedly been lengthened as a result of our
increased knowledge concerning the prevention of disease. Many
scientists have in this way done much for the age in which they lived
and also for future ages. Bnt all was not easy sailing for these
scientists, any more than it is for the men devoting their energies to
the preservation of the public health today, and the fingers of derision
have in the past, as in the present, l>cen pointed at the men who
advocated various measures for the good health of their fellow men.
All of us can remember the opposition that vaccination against small-
pox met with in the past hut today there are but few that are not con-
vinced what a great boon this simple measure has been and always
will remain to the human race. Various measures to control or prevent
typhoid fever that today are observed by all educated and thinking
people have in the past met with scepticism, in fact it may he stated in a
general way that any measure advocated for the good of the public
health is pretty certain of meeting with considerable opposition; this
is a peculiar, but nevertheless a true fact. But persistence, patience and
perseverance gradually win out in all things, and today many measures,
having in view the prevention of disease, that were formerly held up
to derision and scorn, arc quite generally observed.
We have all through the Southern States a disease that prevails in
practically all warm countries, a disease that causes more sickness and
suffering than any other three diseases and one to which the United
States of America pays a toll amounting to $100,000,000 every year,
in addition to thousands of lives sacrificed, and causing sickness, suffer-
ing and loss of time to the wage earner among hundreds of thousands
of our citizens. This disease is malaria and ponder well over the
following sentence, "Malaria is an entirely preventable disease." Mark
you, it is not a disease that can be partially prevented, or one that can
be prevented in some instances, but it is an "entirely preventable
disease." Dependent on the measures used, it could be stamped out by
an entire nation or any part of that nation, by a State or any part of that
State, by a county or any part of that county, all individuals in a town
can prevent the disease from attacking them, and even in the absence
<52)
of collective and concerted action, die individual by taking certain pre-
cautions and carefully observing certain well defined directions, can
prevent himself from becoming infected with malaria, regardless of
the actions of his neighbors.
The natural query now is "how prevent a disease that is so uni-
versal, that comes as the warm weather approaches and increases as
each succeeding summer month passes?"
The answer "protect yourself from the bites of mosquitoes." If
mosquitoes were prevented from biting man malaria, perforce, would
disappear. Ah, but you say, "Impossible!" one can not live ip Florida
or other Southern States without mosquitoes getting at you sometimes.
But here again is the most significant statement yet made and one that
immediately puts a different light on the practicability of the advice,
"protect yourself from the bites of mosquitoes," for we add, "at night."
Mosduitoes that bite during the day are harmless and are not capable
of transmitting malaria. The insect that infects man with malaria bites
only between sundown and sunrise or near those hours, so that the
person who protects himself against the bites of mosquitoes during
these hours will not contract malaria. But the pessimist may say,
"Easy statements to make but how can you prove what you say?" And
here is the most interesting chapter concerning the history of malaria.
While it might be interesting to a few it is not practical in an article
like this to recount the entire history concerning the scientific study of
malaria, its causes, prevention and treatment ; suffice it to say that this
history covers a period antedating the birth of Christ up to the building
of the Panama Canal, the completion of this engineering feat being
what may be considered at the present time the closing chapter of _ the
history of this dangerous disease. That portion of the history con-
cerning how it was proven that mosquitoes carry malaria to man, and
that the disease can be contracted in no other way, is however of
practical interest and a story that should be familiar to all who live in
malarial countries.
It was in the year 1900 that it was definitely determined by scien-
tists, who had been carrying on experiments for some time, that the
actual manner in which man became infected with malaria is by being
bitten with mosquitoes, and to prove that their findings are correct,
carried out the following procedure. Possibly we are a little ahead of
our story — and it should be stated before going further that it was
not thought that ALL mosquitoes carried malaria, but only certain
species or varieties, and these only after they had fed on the blood of
an individual suffering with malaria.
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Now at this time (1900) malaria was a very common disease in
Italy and mosquitoes were very numerous. On the other ham! ma-
laria was practically an unknown disease in London, England, except
for the cases that came into the city from malaria- infected regions,
that is to say no cases of malarial fever were contracted in London,
nor had &ny been contracted there for many years. To prove there-
fore, beyond any doubt, that mosquitoes gave malaria to man, a num-
ber of the insects! were captured in Italy, allowed to feed on the blood
of men suffering from malaria, and then transported to London, where
they wen: allowed to bite two gentlemen who never previously had
had malaria, or had lived outside of London. Both of these men a
very few days later came down with attacks of malaria, and similar
parasites were found in their blood as had previously been found in
the blood of the men on whom the mosquitoes first fed in Italy. Now
this demonstrated pretty conclusively that mosquitoes carry malaria
to man, but it did not prove that there are no other ways in which
the disease can be contracted, and if this discovery is to be of practical
value to mankind it is necessary to satisfy ourselves that the fever can
not be contracted under any circumstances other than through the
bite of malaria-infected mosquitoes.
There is little doubt that the most popular opinion held by the
general public concerning the cause of malaria is that we contract the
disease from the air, some holding that it is the miasmas common around
swamps, others that breathing night air caused one to become infected.
Now, satisfied among themselves that these and other similar theories
were not correct, a number of gentlemen determined to live for
several months in a severely malaria infected locality and at a time
of the year when the disease is at its highest point, taking no precau-
tions against the disease other than protecting themselves against
the bites of the mosquitoes. They accordingly took up their residence
in Ostia, a settlement in the Roman Campagna noted at that time for
the prevalence of malaria and for the severity of the infections con-
tracted there. They were most careful in their preparations, which
consisted of making their little house absolutely mosquito proof, this
being attained of course by carefully screening. Other than living in
this mosquito proof house, to which they retired shortly before sun-
down — remaining there until after sunrise, they took no other steps
against contracting malaria ; they drank the same water, ate the same
quality of food as the natives of the place, exposed themselves to the
sun and to all kinds of weather — in fact, led exactlv the same kind of
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a life as their neighbors, the natives, with the one exception of Laving
protection against the bites of mosquitoes between sundown and sun-
rise. Not a single member of the party contracted a case of malaria
during the entire three months, while the native residents of the settle-
ment wiMout an exception had attacks of malaria during the same
period.
So it has been proven beyond a doubt that
(1) Mosquitoes carry malaria from man to man.
(2) That* the disease can be contracted in no way other than by
being bit! en by malaria-carrying mosquitoes.
With these two most important points definitely determined beyond
any possibility of a doubt, it is now necessary to consider from a
practical standpoint what we can do to prevent ourselves from be-
coming ill with malaria. It was stated in a previous paragraph of
this article that a nation, State, country, or town, could by independent
action stamp out the disease from their respective localities. Pos-
sibly we get away from the practical side of the prevention of malaria
when wie say that a nation such as ours could stamp out the infection
from shore to shore, but it is true, nevertheless, that by the united
actions of federal, State, county, and municipality officials, together
with the individual, we could, if we would, eliminate the disease en-
tirely. It may be safely stated, however, that the position taken by
the individual and his interest in the elimination of any disease is
really the most important unit in the stamping out of any disease.
Just so :n malaria — federal, State, county, and municipal officials
would be practically helpless if they did not have behind them the
co-operation of the individual, so that inasmuch as this article is in-
tended for the individual we shall not discuss the broad subject of
federal, State, county, or municipal actions that are necessary for the
prevention and eradication of malaria, but will confine ourselves to the
measures that followed out by the individual will prevent that indi-
vidual from contracting malaria, regardless of the action of his neigh-
bor.
We have shown that malaria is given to man by the mosquito, but
it is also true that man gives malaria to the mosquito, so that with
the presence of malaria-infected man and mosquitoes of certain species
we have a continuous cycle in the propagation of malaria. Remove
either the "mosquito" or the "malaria-infected man" and the disease .
would have to disappear. It is often asked if mosquitoes give malaria
to man, and man give the mosquitoes malaria, where did the disease
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originate? This question cannot be answered any more than many
other questions pertaining to the evolution of both animal and vegeta-
ble life. There are many things concerning the past that are just
as impossible of our understanding as are many things concerning the
future. We will now briefly consider what takes place when man
and the mosquito become infected with malaria, considering first the
infection of man. A mosquito infected with malaria bites man, in-
jecting ac the time of her biting saliva which contains numerous little
parasites. These at once gain entrance to the red cells of man's blood
and gradually grow, becoming larger and larger. After a definite
length of time the single parasite occupying a single red cell has by
a process of evolution multiplied and instead of a single parasite there
are in this red cell from 18 to 24 parasites. The red cell now ruptures
and the chill familiar to all living in malarial countries takes place. In
certain types of malaria (there are four types) there is no chill —
simply a decided rise in the temperature or fever. Following the chill
or rise in temperature each of the IS to £4 parasites enter other red
cells, this process going on indefinitely depending on treatment or cer-
tain other conditions. This in a brief manner describes how man be-
came infected with malaria and what follows after the parasites are
once introduced by the mosquitoes. We will now consider how the
mosquito becomes infected with malaria by man.
After the process just described, as taking place in the blood of
man, goes on for a certain length of time certain of the parasites that
re-enter otber red cells undergo a transformation or change — -that is
an evolution. They take on different shapes and remain as such while
in the blood of man. These are termed sexual forms and while they
do not undergo any change in the blood of man, as soon as they are
sucked up by the mosquito, while this insect is biting man, and reach
the stomach of the insect, changes or evolution is once more under
way. These so called* sexual forms constitute both male and female
and while it is not practical in an article of this nature to follow the
parasite through all its stages of evolution it may briefly be stated
that as a result of the female being fertilized by the male, which
occurs as soon as the forms reach the stomach of the mosquito, bodies
are formed which result in the formation of tiny parasites which
finally become lodged in the salivary gland of the mosquito, later be-
coming free in the saliva and being the tiny parasite with which the
mosquito infests man with malaria. The process is repeated again
and again and so we have and now can see and understand the cycles
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of the evolution of the malarial parasites in both man and mosquitoes.
Is it not now easy to understand, reader, the previous statement, re-
move either the "mosquito" or "malaria-infected man" and the dis-
ease will have to disappear. Now it is very evident that The individual
is helpless in regard to the removal of the mosquitoes; it would mani-
festly be useless for him to destroy the breeding - places in his own
yard if his neighbor took no measures to destroy those in his. It is
also evident that the individual is unable to remove "malaria-infected
man." What, then, is the practical manner for the individual to fight
against malarial infection? "Protect yourself from the bites of mos-
quitoes between the hours of sundown and sunrise." A simple measure,
not as hard or impractical to carry out as it may seem to those who
have never tried it, but nevertheless one that requires the careful ob-
servance of certain well defined rules — all having in view protection
against the bites of malaria carrying mosquitoes — but by the strict
observance of these it is within the power of any man, woman, or
child, regardless of how much malaria there is in their community,
or of the actions of their neighbors, to keep from becoming infected
with malaria. Individual efforts toward malarial prevention should
consist in the destruction of all mosquitoes within the home, the proper
and efficient screening of the home, and the sleeping under mosquito
canopies.
Even the children of a household can engage in a morning hunt
for the mosquito within the home, and by looking closely in the
closets and dark room corners many of the insects will be found and
can be destroyed. Any parent would be well repaid for stimulating
an interest among their children in the method of mosquito destruc-
tion, by giving a weekly prize to the youngster having the biggest catch
at each week end. Sulphur and other insecticides may be burned in
a house, the mosquitoes gathered up with a broom and destroyed.
The use of certain oils, such as citronella, will give a certain amount
of protection against the bites of the insect, but their use is not very
satisfactory.
Probably the most important individual aid toward the prevention
of malaria is the use of efficient screening. Have your window's, doors
and verandahs all screened, and remember that the greatest curse is
imperfect screening. There is nothing more dangerous than fancied
protection, a protection in which you feel secure, but as a matter of
fact is imperfect. The size of the mesh Is an important consideration —
nothing larger than eighteen to the inch is a safe screen in a malarial
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country. Windows should be screened their entire length, in a manner
that the raising or lowering of the window does not interfere or
necessitate the removal of the screen. A simple and efficient manner
to screen windows is to tack the screening on the window casing, cov-
ering the edges of the wire with a narrow moulding. All doors should
be well scieened and care maintained in keeping them closed. All fire-
places and chimney holes not in use should be stopped up; in fact,
there must not be an opening of any description within the house that
is not either screened or closed up. The screening of the verandah is
a very important point. It is not uncommon to see a perfectly screened
home in so far as doors and windows are concerned, but the good
work all spoiled by the family on a hot summer evening sitting on the
verandah with no protection against the malaria-carrying invader.
MOSQUITO CANOPIES.
Again, it matters not how well the home may be screened, it is
probable that some mosquitoes will find their way in. On this account
no person is absolutely safe from malaria, in a malarial country, that
does not sleep under a mosquito canopy. It should also be remem-
bered that the insects can bite through the netting if any portion of
the body is in contact with the net. The net should, therefore, be
large enough to insure against such an accident. All these little points
may seem trivial, but it is the lack of observing them that is the cause
of many a case of malaria among families who honestly think they
are taking every precaution against the infection, and gives the sceptic
ground for scorning the preventive measures taken by his neighbors
who believe in doing everything possible to prevent the disease.
There is little doubt that a great deal of malaria results from the
careless use of the canopy. It should be borne in mind that the slight-
est tear will allow the ingress of the insect intent on a meal of fresh
blood, so that it is very important that a careful inspection be made
of the canopies in use. A most important point is the manner in which
the net is hung. It is a common occurrence to see them hanging in
such a manner that the edges are several inches from the floor, this
allowing a point of entering. They should reach the floor and be
weighted in such a manner as not to allow draughts to raise them
from the floor. It is not uncommon to find that the canopies are not
lowered until the hour of retiring. This often results in shutting in
within the canopy stray mosquitoes that may be in the room. To avoid
this all canopies should be either put down when the bedroom work
is completed or else lowered early in the afternoon before any mos-
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quitoes are flying around. It is this attention to detail that will keep
one free from malarial infection, for the slogan of the individual aim-
ing at this exemption should be: "Protect yourself from the bites of
mosquitoes between the hours of sundown and sunrise."
Note — The foregoing article has been contributed by Dr. G. E. Henson, who,
while not connected with the State Board of Health, has given very generously
of his time to the public health, and particularly to malaria. — Ed.
HYDROPHOBIA IN FLORIDA.
Rabies, which among human beings is commonly called hydro-
phobia, is a disease that prevails in Florida because laws are rot en-
forced. It might be eradicated if the authorities would perform their
duties, and probably this would be accomplished if a strong public
sentiment demanded it. But the citizens of the State are indifferent,
and they pay the penalty. They pay it with the sacrifice of several
human lives each year and with $20,000 or §30,000, perhaps more,
of good money.
Take the records for the past two years in Florida — 1911 and
1912 — and they show that the State Board of Health had official in-
formation of 115 cases in 1911 and 114 in 1912. There were four
deaths each year. The cost of the Pasteur treatment administered
through the Board was $1,150 in 1911 and $2,052.90 in 1912, and these
figures do not include the expenses of patients who went at their own
cost to the Pasteur sanitariums at Atlanta and elsewhere. It does not
include the much larger cost in the loss of valuable animals, dogs,
horses, mules and cattle — for any and all of the domestic animals may
have it. It is impossible to gather accurate figures of this loss for the
entire State, but in Duval county alone it ran above $15,000 last year.
Rabies is a disease that exists in every season. Summer heat or
winter cold makes no difference. It exists in every part of Florida.
Examining the records of the State Board of Health for 1912, as of a
typical year (although statistics show that the disease is increasing
and not diminishing from year to year), it is found that cases were
reported from twenty-one of the forty-eight counties of the State. Of
the 114 cases, 48 occurred in Jacksonville;. 30 in Hillsborough county
(29 of them in Tampa), and six in St. Augustine, while the remaining
30 cases were scattered through 18 counties, none of which contained
any large cities. Strangely enough, no cases were reported from Pen-
sacola or Key West. This might be explained by the isolation of the
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latter city from the mainland of the State, and by the enforcement of
law in the former.
Ninety-four cases observed by the Board were of white patients,
and twenty of colored persons. Sixty-three were persons over fifteen
years old, and fifty-one under that age. Ninety-four were bitten by
dogs, ten by cats, one was licked in the mouth by a dog that afterward
became rabid ; three caught the disease by coming in contact with the
saliva of a cow supposed to be sick, but which later developed rabies ;
one got it from the saliva of a rabid calf, and one was exposed to the
saliva from a rabid horse.
Each of these facts has its significance. It appears that the dis-
ease prevails more generally in the cities, in the thickly settled sec-
tions, than in the rural districts.
While dogs are the principal source of the infection, several other
animals have become dangerous.
The doctors don't know everything about the disease. They are
studying it constantly for the benefit of humanity, and they have found
that the Pasteur treatment, when taken in time and administered
faithfully, is a practically sure cure. There are a few basic facts that
everybody ought to know.
Rabies is probably a germ disease, for in every post-mortem ex-
amination are found what are known as the Negri bodies, so called
from Prof. Negri, of Pavia University, Germany, who identified them
in 1903. The disease is communicated through the saliva of infected
animals containing these bodies. These are carried through the circu-
latory system and affect the nerve system, of which the brain is the
center. They are found developed to the greatest numbers in the large
ganglion cells of the brain. The reflex action on the body is to para-
lyze the natural functions, particularly of the heart and lungs, so that
the patient, unattended, may may die of irregular heart action or of
strangulation, through a paralysis of the muscles of these organs. So
far as has been observed, the digestive system is affected only in sym-
pathy with other affected parts. The patient is thrown into a highly
nervous condition; his mentality is rendered abnormally sensitive to
outward impressions. As a consequence, his mental suffering is in-
tensified, and death from this disease is the most horrible known to the
medical profession.
The aversion to water, which is commonly supposed to be a dis-
tinctive feature of rabies, is caused not by a distaste for the fluid, but
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by the agony of the attempt to swallow, caused by the paralysis of the
throat muscles.
The disease may be communicated to human beings and to all do-
mestic animals, as has already been noted. It may be communicated
also to wild animals, and there is some evidence that this has already
occurred in Florida. The wild wolves on the vast plains of Russia
have become infected and have become a serious menace in the sparsely-
settled sections of that country. It is possible in Florida.
The conclusion from observed and proven facts warrants the state-
ment that the disease can be stamped out in the State. Once this has
been accomplished, it cannot be revived excepting by importation from
other States and sections.
There is just one way to stamp it out, and that is to enforce the
laws regarding dogs, for it is perpetuated through dogs. First, insist
that every owner of a dog shall pay a license for that dog. Second,
insist that every dog allowed to run at large shall be effectively
muzzled.
That's all, excepting to insist that city and town and county au-
thorities charged with the enforcement of these laws shall do their
duties or give place to those who will.
A good many dogs are not worth the license fee, and the license
tag should be the permit for every canine to live. If necessary, extend
the operation of these laws to cats— and cats are a nuisance in other
ways besides this.
Good lawyers declare that the municipality or county having such
laws is liable for damages resulting from the non -enforcement of these
laws. But why wait for such action ? Why should such sacrifices be
necessary to arouse public sentiment, when an evident danger of such
seriousness constantly menaces the people in every community in Flor-
ida? — Press Service, State Board of Health,
SPEAKING OF SMALLPOX.
The office has just had report of a young white man at Ocala who
died of hemorrhagic smallpox. Hemorrhagic smallpox is different
from ordinary smallpox only in severity, that is to say, a person may
contract hemorrhagic smallpox from the common kind, and vice versa.
It is generally known that a person has a rise of temperature, head-
ache, backache, etc., two or three days before eruption of smallpox.
In hemorrhagic smallpox the eruption never forms, but instead, hem-
orrhages occur under the skin, mottling it with black and blue patches
(61)
which may completely cover the body. In this state the patient dies
very promptly ; there are no recoveries from hemorrhagic smallpox.
It is sometimes called "black smallpox/' just as hemorrhagic measles
is called "black measles." Scarlet fever may also be so malignant as
to be hemorrhagic, and epidemic cerebrospinal meningitis is some-
times called "spotted fever," from the fact that in a large number of
cases of that disease these little hemorrhages occur under the skin.
The young man in question had never been vaccinated.
Quite recently a Greek woman in Jacksonville, who did not speak
English, broke out with an eruption. The attending physician thought
that i.t was chicken pox, but admitted it might be smallpox. Another
physician saw it, and thought it was smallpox, but admitted it might
be chicken pox. The State Board of Health was called upon to pass
final judgment. The eruption in question was of "borderland"' type,
which deries absolute diagnosis. While conducting the examination,
a little daughter of the woman about ten years old acted as interpreter.
Inquiry was made as to whether the mother had ever been vaccinated.
It was found that she had been vaccinated many years ago, but the
scar was very atypical, almost faded out. There was reasonable doubt
as to whether the vaccination had ever been successful. While talk-
ing with the little girl it was discovered that she had a little pustule
in her eyebrow. Further inquiry revealed the fact that she had this
eruption a,lso. The eruption on the shoulders and chest were fairly
profuse. She developed it about the same time that the mother did,
but she had so little in the face that it had not before attracted atten-
tion. Upon being asked if she was vaccinated, it was found that she
was recently, and had a typical vaccination scar. This showed it was
not smallpox, but chickenpox, and the diagnosis was established. It
will be noted in this connection that the diagnosis was based upon
the vaccination history rather than upon the character of the eruption
for the symptoms of the disease. A diagnosis of this kind is abso-
lutely reliable.
The following is a condensation of the work of the Board for the
month of February, which will be of interest to the public :
During February smallpox was reported from sixteen counties,
viz. : Alachua, 17 cases : Bradford. 1 ; Dade, 1 : Duval, 25 ; Escambia,
13' ; HiI!sboro ; 1 ; Leon, 4 : Levy, 10 ; Madison, 1 ; Manatee, 6 ; Marion,
(62)
1 ; Nassau, 1 ; Putnam, 1 ; Santa Rosa, 2 ; St. Johns 2 ; Taylor, 1 ; a
total of 211 cases for the State,
The cost of vaccine distributed during February was $171.92.5.
Twenty-five "hundred points of vaccine were purchased during the
month, and 2,645 points distributed in 23 counties.
The number of persons taking anti-rabic treatment in February
was ten, of which three were treated at the expense of the State. The
sum paid by the State Board of Health for treatment of indigent cases
against hydrophobia in February was $100.00.
During February the Board paid for diphtheria antitoxin given
to the indigent in the State, in the amount of $42.80.
There were no applications received for relief of crippled children
under the State fund during February.
No publications were issued by the State Board of Health in Feb-
ruary, but a quantity of reprints from the Southern Medical Journal,
entitled "Some Things That People Should and Should Not Forget,"
by Dr. Joseph Y. Porter, were received for distribution.
During February applications were received and hog cholera serum
distributed to the amount of 26,000 c. c. Of this, reports were re-
ceived of 13,475 c. c. being administered to 535 hogs, total weight of
which was 38,760 pounds; 25,000 c. c. of hog cholera serum was pur-
chased during February, at a cost of $375.00; 15,000 c. c. of serum
was on hand March 1st. No hog cholera agents were appointed dur-
ing the month, but requests for serum were received from four un-
recorded owners. Total number of hog raisers recorded as applying
serum on March 1 was 28, and the number of hog cholera agents
numbered 104. Total amount of serum on hand by agents and own-
ers on March 1st was 92,640 c. c. One thousand c. c. of serum was
destroyed in transit, and claim instituted.
There were four cases of glanders reported in the State in Febru-
ary. Three hundred and seventy- five dollars was paid by the Board
as reimbursement for glandered animals killed by order of the Board
during February.
On February 9th the Alachua County Live Stock Club was or-
ganized, with a membership of 20. February 11th the State Board
of Health, in annual session, authorized an expenditure up to $5,000
for cattle tick eradication in Florida for the year 1913. On Febru-
ary 14th, on recommendation of Dr. C. F. Dawson, veterinarian of the
State Board of Health, that in all counties where clubs are organized
for tick eradication, the State assume the expe'nse of erection of vat
(63)
for demonstration purposes with reports of demonstration^ and ac-
tivities in this line, was adopted by the State Board of Health On
February 22d the first cattle dipping demonstration in Florida was
held at the farm of Hon. C. F. Barber, at Macclenny, where vat had
been installed. One hundred and fifty animals were dipped before
an assemblage of one hundred people. Speeches were made and the
event published.
During- February the number of pieces outgoing mail was 550,
first clasi; 136 for all other mail — total, 686 pieces, the postage of
which was $15.70.
Two thousand eight hundred and twenty-three pieces of literature
were distributed during February in 24 counties by the Board.
A HOME SNUGGERY.
There should always be one spot in the home sacred to the best
interests of the family. A room full of comfort, where the sofa is
made to lounge on, and the chairs to tilt back, and the carpet to dig
the toes in; where bills and bickerings are alike forbidden, and the
straight laced propriety of the dining room or parlor can be abandoned
for romps and story telling; where the dust doesn't show and nothing
is too fine to use, and at whose door all the burdens drop off as they
will some time at the gate of heaven — a room whose speech is silver
and whose silence is golden — where the tranquility of a summer Sab-
bath is broken only by sweet murmurs of love and confidence, where
a happy cat curls herself to repose in blissful affinity with the peaceful
house dog, a place where the wicked cease from troubling and the
weary are at rest. A sort of moral lean-to which adjoins the house-
beautiful. Here Jacob's ladder is planted, and the angels descending,
bring with them endless measures of peace.
Every home should have this one place of retreat.
It is no impossible place. Love is the architect; content its atmos-
phere. We find it in our friends' homes, often, where least expected,
and are surprised because it is never a show place. It is simply a
golden room in a wooden house. — Palm Beach Weekly News.
JAP BAKER'S SIGN.
The oriental capacity for using our mother tongue with strange
twists of unconscious humor is well known, but few examples are
equal to this delicious sign on a Japanese baker's shop: "A. Karin-
ura, Biggest Loafer in Tokyo." — Oriental Review.
(64)
„ NOTICE— EMBALMER'S EXAMINATION.
Fridav, May 16th, Jacksonville, Fla„ offices State Board of Health.
HOUSEHOLD CLEANLINESS AND YAWS.
We have with us some of the tropical diseases, but not all, thanks
be. Yaws, for example. A recent trip to Jamaica emphasizes how
grateful we ought to be for that. The disease is quite prevalent there.
Not so much in Kingston, but in the poorer suburbs, and in the coun-
try. The natives believe they have to have it and make no provision
against it. In fact, they treat it like measles — try to get it while they
are young and have done with it.
As a matter of fact they need not have it at all. Few Europeans
or Americans, even where the disease is most prevalent, ever contract
it. For a while it was not known why, but now that is pretty well
understood. The disease is transmitted by bed bugs. Those who live
in environments that do not harbor bed bugs don't get yaws,
It is hard to imagine a more loathsome disease than yaws. It con-
sists of ulcers, which may be sprinkled over the entire body, or may
be confined to some particular area. These ulcers may be many or
few. At best they last for several weeks, and may last for months or
even years
They are seen mostly in children, because one attack confers im-
munity. When children have them and get well, they rarely have
the disease a second time. But they are not confined to children. Any
age may become infected.
The eternal lesson taught by this disease is that household cleanli-
ness prevents it.
COULDN'T RECIPROCATE.
A Scottish farmer was asked to the funeral of a neighbor's wife,
and as he had attended the funeral of both of her predecessors, his
own wife was rather surprised when he informed her that he had
declined the invitation.
For some time Sandy would give no reason for the refusal, but he
could not stand the old lady off. so finally he told her with some hesita-
tion:
"Weel, ye see, Janet, I dinna aye like to be acceptin' ither folks'
civilities when I niver hae anything o' the kin' to offer in return." —
Exchange.
B«ord Company St. Augurtint, 51970
^VORI^
Health
Notes
OFFICIAL BULLETIN
Published Monthly by the
STATE BOARD OF HEALTH
Subscription 50 Cents per Annum
Entered as Second Class Matter, April 20, 1910,
AT the Postoffice at St. Augustine, Florida, Under the Act of July 18, 1894,
Vol. VIII
April, 1913
No. 4 (££)
Hon. E. M. Hendry, President, Hon. H. L. Simpson, M. D.,
Tampa, Fia, Hon, John G. Christopher, Pensacola, Fla.
Jacksonville, Fla,
Edited by
Joseph Y. Porter, M. D„ Secretary and State Health Officer.
Hiram Bvrd, M. D., Assistant State Health Officer,
EXECUTIVE OFFICE AND CENTRAL, LABORATORY ;
State Board of Health Building,
Springfield Boulevard,
Jacksonville.
BRANCH LABORATOHIES :
State Board of Health Building
Florida Avenue and Constant Street, Tampa.
City Hal), Pensacola.
Sent to any address in the State for the asking.
If you receive it without asking, it means that someone else has requested
it for you.
When you change; your address drop us a card.
When giving change of address, give both the old and the new.
Anything you want to know about the public health we will try to tell you.
Any information you want about communicable diseases of domestic animals
we will help you to get.
Address communications to Jacksonville, F!a.
(«)
MOSQUITOES.
To the casual observer all mosquitoes look alike, but a more inti-
mate acquaintance reveals some very striking differences both in
structure and habits. Some are beautifully marked with white or
yellow stripes and bands, some with purple and scarlet, while some
are of more somber hues. Some have long slender legs, others short
and stout. The legs of some are smooth, while others are beset with
erect scales. Some have toothed tarsal claws, while others are tooth-
less. Some do not bile at all. Some bite chiefly at night, some chiefly
in the day, whereas some bite day and night. Some pass the winter
in the adult and some in the egg stage. Some deposit their eggs on
the water; others deposit them on the grass or mud, where water is
expected to be after heavy rains or high tides. Some lay their eggs
singly; others join them together into little batches, or boats. Some
breed only in fresh water: others only in salt or brackish water. Some
prefer clean water ; others filthy. Some are migratory ; others are not.
Some transmit one kind of disease, others another, while yet others
are innocent altogether. Although there are many differences, there
are also many likenesses, and it is these likenesses and differences that
enable them to be grouped together and labeled. All mosquitoes that
are alike in certain fundamental respects are grouped together as a
genus, but among the mosquitoes thus grouped together will be found
certain minor differences. The mosquitoes that are alike even down
to minor points are grouped together as a species. When speaking
or writing of mosquitoes, as with animals or plants, it is necessary
to give both the genus and the species, just as we expect John
Smith to give both surname and individual name jointly. To illus-
trate ; The Anopheles have long palpi in both sexes, and the larvae
have short breathing tubes. So far they are alike, but one kind of
Anopheles has three black spots on the scales of the last vein of the
wing; also white bands across the palpi. This is the species crucians,
and is spoken of as the Anopheles crucians. Another Anopheles has
white feet. This species is known as the Anopheles argyritarsis.
NAMING SPECIES.
It is an unwritten law among naturalists that the first who finds
or describes a species names it. Frequently two or more naturalists
in different parts of the world describe the same species, each naming
it and each giving it a different name, and later it is found they both
mean the same thing. When this occurs, the species is known by
the name given first, and the other names are given as synonyms,
(67)
e. g., a certain mosquito of the genus Anopheles was described by
Meigen and called Anopheles niaculipennis. The same mosquito was
described by Say and called Anopheles qtiadrimaculatus. It is now
known as Anopheles maculipennis, Meigen, the other name, Anopheles
quadrimaculatus, Say, being used as a synonym, and the author's
name appended in each instance to avoid confusion.
KINDS (SPECIES).
Just how many kinds of mosquitoes there are in the world nobody
knows; no one will ever know, perhaps. Distributed over the world
as they are. there are large areas in which the mosquito fauna is not
known, and will not be for years to come. Writing ten years ago,
Lieutenant Colonel Geo. M. Giles, whose validity is hardly likely to
be questioned, says: "We have at least three hundred species." Three
years later, F. V. Theobald, who is one of the greatest living author-
ities on mosquitoes, stated the number of species "will not stop short
of a thousand*". In the State of Florida we have about thirty known
species. There may be others; probably are. We have a large ter-
ritory, though not very diverse conditions, aud it is not likely that
the limited amount of work that has been done has unearthed them
all by any means.
GENERA.
The number of genera into which mosquitoes have been grouped
is about fifty. We have found in our State representatives of about
a dozen of' these. The Culex includes about as many species as all
the other genera together, more than 160 already being known.
And if any genus may be regarded as the type from which others
have diverged, the Culex has a very strong claim for that distinction.
Selecting, then, the Culex pipiens as type of this typical genus, the
life cycle is briefly as follows:
wigglers.
Mosquitoes pass through four stages of development — egg, larva,
imago, and fullgrown mosquito. However the eggs may be laid, they
hatch only in water; the wiggler and pupa pass their entire existence
in water, leaving it only when the imago emerges from the pupa skin.
From this it will appear that mosquitoes cannot breed except in water.
Though the wiggler lives in water, he is a true air-breather. Res-
piration is carried on by means of a respiratory siphon situated on
the dorsal aspect of the last abdominal segment — a breathing tube
*Note. — Animal Parasites of Man, by Braun.
(68)
near the end of his "tail." When at rest he floats at the surface, head
downward, his breathing tube thrust out of the water. If disturbed,
he quickly darts downward, but soon returns to breathe again.
Frequently he may be seen feeding at the surface, and actively
turning his head and body this way and that, but always with his
breathing tube thrust into the air. At other times he goes down to
feed, and may he seen mouthing over dirt, leaves, grass, , or whatever
happens to be in the water. His food consists of diatoms, desmids,
spores of minute vegetable organisms and minute animal life. He is
a very voracious eater, and when food is scarce he will, in some
species, eat other wigglers.
He grows fast or slow, according to the abundance of food at his
command, the temperature of the water he lives in, etc. In about a
week, under ordinary conditions, he is grown, having moulted several
times in the interim. He is now ready to change his skin once more,
and out comes the pupa.
PUPAE.
The pupa looks something like the mosquito with his head, wings,
thorax, and legs all in a bag. With the change of state his habits also
change. He doesn't grow any more, neither does he eat. His breath-
ing is changed so that now it is through two little trumpet-shaped
tubes that grow out from the thorax. His body seems to have be-
come lighter. He quietly floats at the surface, except when disturbed.
At such times he darts downward, but it is only by effort that he
remains below the surface.
HATCHING.
After remaining in the pupa stage from sixteen hours to three or
four days, he bursts his skin on the back of the thorax and out comes
the full-grown mosquito. During the hatching, which takes place in
the water, the pupa skin serves as a boat to keep the emerging mos-
quito from drowning.
If he passes this milestone safely, he unfolds his legs, rests a bit,
spreads his wings and flies away.
MATING.
Late in the afternoon of the spring and summer, you may see large
swarms of insects rapidly dancing among one another and keeping
about six feet above the ground. If you walk after them, they will
move before you, keeping about one step ahead. If you turn and
walk the other way, they will get in front of you again. If you pass
your hand rapidly among them, they will disperse for the moment,
but in a few seconds will be reassembled. I have made a quick swoop
with an insect net and caught a score. Examining them, it is found
that they are mosquitoes— our common rain barrel mosquitoes — the
Culex pipiens. And what is more, they are all males. This is appar-
ently a "bachelor party." But what is the explanation? If you watch
them closely, you will see, every few seconds, if the swarm is large,
two mosquitoes clasp and soar away. If you capture these, you will
find that it is male and female. It is the nuptial flight. The bachelors,
so to speak, are being auctioned off. But why do the bachelors con-
gregate preparatory' to this wedding feast? Why do they seek human
audience? Why this particular hour? this particular height above
the ground?
Where the Stegomyia calopus are abundant, it is easy to be a
guest at the wedding. Better choose a porch, preferably screened
with vines, such as lovers like, where the light is subdued. The best
hour is about the time the school bell rings, though a little earlier, or
a little later or even in the afternoon, will do. Then keep still, for
these denizens of the smaller world are very shv.
It has been stated on good authority that the Anopheles, at least
in common with most insects, mate only once in life; that the males
don't live long afterwards, and that the females are ever afterwards
fertile. But Mitchell is authority for the fact that the Stegomyia
calopus is very fickle.
DISTRIBUTION".
With the possible exception of a few uninhabited or almost unin-
habited islands, mosquitoes are to be found in all parts of the world.
They seem to be more prevalent in the extreme northern latitudes
and in the tropics; less so in the temperate regions. The reason for
this is apparently one of development of natural resources of the
country. The temperate regions, not too cold in winter, not too hot
in summer, have been first to attract men. and it is there that possi-
bilities of the soil and of the streams have been developed to the
highest point. It is there that drainage has been completest, the dens-
ity of population having made imperative the utilization of the land
and of the water, whereas the development of the far northern and
of the tropical countries has not kept pace. We have every assurance
that mosquitoes abound in Alaska, sometimes in inconceivable num-
bers. It is stated on good authority that they attack the polar bear
with such ferocity as to even result in his death. In Lapland the
herds often stampede on account of this veritable pest. It goes without
(70)
saying that the same kind of mosquitoes are not distributed all over
the earth, but in some instances an individual species may have a very
wide range of distribution. The Culex impiger, for example, has
been reported both from Alaska and from Florida. In Florida, which
is practically all in the humid division of the lower Austral life zone,
there are probably no places entirely destitute of mosquitoes, only a
few species, however, that are so cosmopolitan as to be found all over
the State. The Stegomyia calopus, or yellow fever carrier, is so uni-
versally distributed that it is certain that there is no place within our
bounds in which it does not breed, or would not, with facility, if given
proper conditions. The Culex ptpiens, or common house mosquito, is
another cosmopolitan pest. Probably we have no other species so
widely distributed as these two.
BITING APPARATUS.
The biting apparatus of the female mosquito consists of seven
parts. Beginning in the center there is a little tube which is the
tongue. This tube lays in a gutter, and that makes two canals, one
just above the other, one running through the tube and one just un-
der it, in the gutter. Ranging around this are four lancets, making
six of the seven parts, and wrapped around the whole is an outer tube,
which completes the biting machinery.
In the act of biting, all is inserted except this outer tube, which is
ingeniously arranged for slipping back. This tube is split right on
top, but not all the way down to the end. In the act of biting, all the
biting parts are thrust into the skin, the little unsplit portion at the
end of the tube keeping around the rest like a ring, and the split
portion in the middle of the tube doubling back upon itself in an
acute angle until the inner parts are inserted their entire length. The
two canals mentioned are specially important features. One of them
communicates directly with the salivary glands and the other with
the stomach. In the act of biting, saliva is flowing out through one
of the canals, while blood is flowing in through the other.
BITING HABITS.
Male mosquitoes do not bite — only the females do. There are
probably some rare exceptions to this, but in a general way it is true.
The females do not generally bite till after they have mated.
There are some very definite exceptions to this. Among the salt
marsh breeders, for example, it is the sexually immature females, the
neuters, so to speak, that are most conspicuous for their ferocity.
(71) » .
But among the fresh water breeders there are no neuters, and the
females generally refuse to bite till after they have mated.
Each species has its own biting habits. The Culex pipiens bites
only in the night, at any hour between dark and dawn. The Anoph-
eles bite mostly in the early part of the night. They sometimes,
though rarely, bite in daylight. On one occasion I saw an Anopheles
crucians bite on a railroad train about ten o'clock in the morning.
Another time I saw one bite in the early afternoon. But this is rare,
and is an important point, for it is this nocturnal habit that enables
people to protect themselves against it.
There are other species that bite only in the day time. The Jan-
thinasania musica, I think, is one of these. Certainly the Stegomyia
calopus is one. In 1905 the author published the following note con-
cerning the biting habits of this mosquito :
Next to knowing at sight the mosquito himself, nothing is more
important than to know the biting habits of the Stegomyia fasciata.
I have seen very little literature upon this particular phase of mosquito
lore, and that little is contradictory, part claiming that he bites chiefly
in the day time, and part that he is of purely nocturnal habits. It is
the purpose of this article, therefore, to state the conditions under
which he bites and does not bite, as I have observed them myself, and
to interpret certain well known phenomena.
Only the females bite and these not until after they have mated.
Having once mated they are always fertile, and, though they may de-
posit during life several litters of eggs, they do not need to mate a
second time.
After mating the females go in quest of blood. When they bite
they fill the stomach very full. They will not bite any more now until
that is all digested. This takes two or three days when the weather
is warm, but when it is cool the vital processes are a little slower, and
it takes somewhat longer.
The Stegomyia calopus have two daily mating periods : one in the
morning, which lasts from early dawn till nine or ten o'clock, and
one in the afternoon, which lasts from four or five o'clock till dark.
More mate in the morning than do in the afternoon. They occasion-
ally mate at all hours of the day, particularly if it be cloudy and still.
They begin biting also at early dawn and by nine or ten o'clock the
biting has reached its height. So it continues till they have become
sated or till the afternoon draws on. After five or six o'clock the biting
subsides in a measure, but does not completely cease till night. If
they ever bite in the dark it is the rarest exception. It is to be added
just here that during the noon hours of our hottest and brightest days
the biting subsides a little.
And though they bite only in the day, they assiduously avoid sun-
Hght. I doubt if one ever makes an attack, no matter how hungry,
(72)
where the sun is shining, or even ventures into sunlight when it can be
avoided. If taken into the sun in captivity, they become restless.
Even in the wiggler and pupa stages they seek the shadiest part of the
vessel. Not only do they avoid the direct light of the sun, but also
avoid bright sky -light, creeping up insiduously on the shaded side,
when they go to make an attack.
They likewise avoid the wind, seldom attacking even in a moderate
breeze and then always on the leeward side.
They are also shy of motion— easily driven away but persistent to
return.
Upon the whole, the Stegomyia calopus is the most wary mosquito
with which I am familiar. Choosing his point of attack, as before
stated, on the shaded side, he carefully reconnoitres the grounds,
apparently weighing the chances of trouble against the delights of the
feast, before he ventures to light. And finally when he does light, he
does not proceed at once to bite, but waits, watching, to see if he is
observed. During this waiting, watching, his hind legs slowly curl
back and forth over his back. At this time be is most difficult to cap-
ture. Finally, when he considers all safe, he begins feeling around
with his proboscis for a suitable place to make the puncture. Then he
stops again and watches, then proceeds again. The least movement
on the part of the victim will frighten him away instantly.
Now, it is a well known fact that during an epidemic of yellow
fever, people may visit the stricken city in the day time and by leaving
before night, enjoy a relative safety. These two facts seem to con-
tradict each other, for if the mosquitoes bite in the day time instead
of the night, how is it that one takes less risk going into an infected
territory in the day time than he does to spend the night there? To
answer this perfectly rational inquiry requires that several things be
borne in mind, not only concerning the mosquito's habits, but the
individual as well. As a rule only men take such risks. They take their
families away and keep them away. They, too, stay away at night.
They go to town in the day to attend to business, but leave again with
the greater possible despatch. Most men smoke. Especially is this
true in the presence of disease. Smoking helps to keep the mosquitoes
away. They attend to business in a hurry. This keeps them on the
move. It has been pointed out above that the Stegomyia calopus will
be frightened away by the least motion. A good portion of the man's
time is spent in the open air — the breeze is protective. And while in
the sunshine they ai "e practically safe, for, as has been seen above, the
Stegomyia calopus avoids sunlight. Furthermore, when a man volun-
tarily takes such chances on account of business interests, he keeps as
well out of the infected district as possible. Now with all these factors
working in his favor the chances are that he will escape, but occasion-
ally he is overtaken in spite of them all.
On the other hand, an individual spending the night in infected
territory takes great risk, because the mosquito bites until night and
begins early in the morning, and the sunlight, which is a restraining
(73)
STEGOM VIA CALOPUS. MEIC. AFTER HOWARD. (MALE.)
STEGOMYIA CALOPUS. MEIG. AFTER HOWARD. (FEMALE.)
(74)
The following or opposite figures, represent the life history of the malarial
parasite :
It will be noticed first of nil that there are two circles. The upper circle Is the
history of the germ as It nai»« through the mosquito. The lower circle Is the history
passing through the human.
Beginning with number 1. on tbe left, the mosquito Is biting a human being and
Injecting one or more malarial parasite*.
1') nitre 2 i* a red blood cell In this, person that is being bitten, with the parasite
Just entering It.
Figure 3 la the same blood cell with the parasite embedded In the center and
growing.
Figure 4 Ik a little Inter singe of the same cell.
Figure ."■ In the saute cell wttli tin- parasite bfeadtlBg ii|> Into clr!n segment*.
Figure H In the tell breaking dowu and setting free lu tbe blood a number of
young parasites. (Note: This Is a crucial point In the cycle. The parasites set free
here arc of three binds: tnale. female and neuter. All three tlnds enter other blood
cells aa the parent did. We will consider tbe neuter first).
Figure 7. It Is entering a new blood cell. It then repeats tbe cycle that Its
parent did. Figures 3, 4, 5, 6 and 7, again. When this breaking dowu takes place, aa
In Figure (I. it is called tpontlotum. It Is here that tbe patient has the chill. It
happens I tertian malaria) every 48 hours.
We will now leave this neater form of parasite and follow the cycle of sexual
forms, represented by Figures S, !». 10 iintl 11. They grow, that In. the sexual forms,
enter other Mood cells as the neuters do, but do not break dowu. They remain
dormant In tbe blood cells that tbey occupy.
Figure 12 is tbe female form, and
Figure 13 the male form.
Figure 14 represeuts a mosquito biting n person Infected with malaria and getting
some of these male and female forms Into his body. Now we go through the other
circle, the one that takes place in the body of the mosquito.
Figure 13 Ik a female form lu the stomach of a mosquito ami
Figure Id. a male form. The three little whip-like projections on Figure IB
break off In the stomach of tbe mosquito, and one of them Is seen to be swimming
along In
Figure 17.
In Figure IS It Is penetrating a female form, which Is now fertilised, as Id
Figure 1!*.
In figure 20 tbls female form Is called n cygote. It now bores through the
stomach wall of tbe mosquito and becomes embedded.
Through Figures 21. 22 and 23. It la making preparation to break down in tbe
body cavity of the mosquito.
In Figure 24 this breaking down takes place and a large number of tiny little
organisms are set free, aa In
Figure 23.
They are excreted by the saliva of the mosquito, which is now Infected, and when
he bites, aa In Figure 1, some of them are Injected and a new case uf malaria la started.
<?5>
\ In the Sh
\ Human Being.
%
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v&m^ jsy"
ADAPTED FROM PLATE ISSUED BY SAN1DAD Y BENEFtCENCIA, CUBA.
(76)
influence, is wanting in the evening; and the mosquito is active long
before the individual wakes in the morning. Indeed it is not unlikely
that more infections take place at this early hour than any other time
of the day. At that time there is usually a dead calm and the light is
not too severe, and the slumberer lies motionless— the happiest com-
bination conceivable for the fastidious habits of the yellow- fever carrier.
Certain other species bite day and night. This is particularly true
of our salt-marsh breeders. The ferocity of these has never been
overdrawn. They seem totally devoid of fear and always bent on
biting. They will bite in captivity as voraciously as when free if only
given a chance. I have seen them bite when three of their six legs
were gone. The Psorophora ciliata also bites day and night. This
is the largest species we have, some specimens measuring over an inch
from head to tail. The author has seen him bite through a kid glove.
HOW MOSQUITOES TRANSMIT MALARIA.
Everyone knows now that the mosquitoes of the genus Anopheles
are responsible for the transmission of malaria. But just how it is
done is not so generally understood. Briefly, the process is as follows :
The hematozoon of malaria develops in the red blood cell, feeding on
its contents and growing just as any other organism would feed and
grow. If you can imagine a worm in the heart of an apple, eating and
growing till the apple is only a shell and the worm fills it up, you will
have a similar process. If you can imagine the worm breaking into
ten to thirty pieces, and each piece entering another apple, and living
and feeding and growing as the first one did, you will still be follow-
ing the process. When the hematozoon grows till it fills the corpuscle
— when it is grown — it breaks into a variable number of pieces or
segments, and the process of breaking out of the old shell and getting
into the new is called sporulation. It is at this juncture that the patient
has the chill. In tertian fever this sporulation takes place every forty-
eight hours. In another two days they are grown and sporulate again,
and another chill, and so on. From this it will be seen that if a patient
has two crops maturing on different days, he will have a chill every day
— a double infection.
It will be noticed that the above method of reproduction is without
sex. Each individual germ, independent of every other, produces ten
to thirty of its kind by breaking into so many segments. This asexual
method of reproduction has for its object the increasing of the number
of individuals. It prevails to a greater or less degree in all the lower
animals and plants. But the malarial parasite, in common with many
other organisms, has another means of reproducing — a sexual method.
It is this sexual method that continues the story.
When the hematozoon growing in the red blood cell reaches ma-
turity and sporulates, as before said, it breaks into ten to thirty seg-
ments. Now these segments are of three kinds, namely, male, female,
and the asexual forms that go on reproducing in the blood. As we
have already seen what the asexual forms do, it now remains to see
what becomes of the sexual forms — male and female. When sporula-
tion takes place and all three forms are set free in the plasma of the
blood, the sexual forms, like the asexual, proceed to enter other blood
cells and feed and grow. But they do not sporulate. Their function
is to disseminate their kind, to reach other hosts. And as they have
adopted the mosquito as their intermediate host, they lie dormant till
taken into the mosquito's stomach. Now when an Anopheles bites an
individual thus infected with malaria, he takes into his stomach a great
number of red blood cells. Some of these contain no germs at all,
some contain the asexual, and some the sexual, both male and female.
The blood cells are digested. So also the asexual germs. Not so the
sexual. Instead they proceed to unite, the males with the females— to
mate, if you please. In this act of conjugating the male and female
elements fuse together, making a new bod}'. This body now penetrates
the stomach wall of the mosquito and here becomes embedded, forming
a minute tubercle. By and by this tubercle breaks down, setting free
in the body cavity of the mosquito a host of minute organisms, called
sporozoites. These get into the salivary glands of the insect, and when
the mosquito bites another individual some of them are injected and
proceed to enter red blood cells and grow and reproduce, and the
story is repeated.
MOSQUITOES AND OTHER DISEASES.
As before said, it is well known that mosquitoes transmit malaria
and yellow fever. It is equally well known that they transmit the
Filaria sanguinis horn in is. They are also accused of transmitting the
specific cause of dengue. Among the lower animals they transmit a
disease of swallows similar to malaria. It is thought also that they
transmit a certain dog disease of the hematozoon class. And it is
altogether probable that diseases among cold-blooded animals may
prove to be transmitted in the same way. There is an infinity of in-
vestigating yet to be done along these lines.
(78)
HOW MOSQUITOES PASS THE WINTER.
Some species, as our salt-marsh breeders, pass the winter in the
egg stage, the adults dying when the weather gets cold, but leaving a
bountiful supply of eggs deposited in the marshes ready to hatch out
when the spring rains come. Others, as the Anopheles, pass the winter
as adults. In the colder latitudes, with the advent of winter, the gravid
females seek shelter in closets, cellars, barns, and other protected
places, and go to sleep. When the warmth of spring returns, they wake
up and set about repcopling the mosquito world. But I am convinced
that the commoner species rarely, if ever, hibernate in this State —
especially the southern part. During the winter of 1903 I found them
out, not only through the winter months, but during the coldest of the
weather. On two successive nights the thermometer went to 20 degrees
Fahrenheit, and on the intervening day my wife captured a large active
specimen of Anopheles crucians. The thermometer then stood about
35 degrees Fahrenheit. During the same cold spell I captured several
other specimens of Anopheles, as well as Stegomyia fasciata and Culex
pipiens. It is true they were not so abundant as when the weather was
warm, nor were they so active, and if the temperature had remained
low for any length of time they would, in all probability, have gone
into hibernation. 1 also found active Culex wigglers in January-, but
was not privileged to see them hatch. But on February 13 I found
grown Culex wigglers which were collected and hatched in breeding
jars.
HOW FAR DO MOSQUITOES FLY ?
It has been definitely settled by Dr. John B. Smith, of New Jersey,
that our two salt-marsh breeders are migratory, that they will fly 20
miles or less from their breeding places. Whether there are other
species that migrate is yet to be determined, but it is certain that most
of our commoner species are of very local habits, seldom flying more
than a few hundred feet or yards at most from where they hatch. It
is very important, therefore, for exterminating purposes, to determine
just what species we have to contend with and how far they fly, for
it is evident that in order to clear any given community of mosquitoes
they must not be allowed to breed within a radius equal to the distance
they may fly.
now loxc no mosquitoes live?
"How long do mosquitoes live?" is a question often asked. It is
not easy to answer, for the reason that, in confinement, they may not
live their allotted time. And the span of life is probably greater in
(73)
some species than others. The Stegomyia fasciatus has been kept alive
for five months. So has the Culex. Mr. Smith thinks that the average
life of our commoner Ctilices is some three or four weeks, and that
Anopheles live somewhat longer. It is certain that they live long
enough to reproduce their offspring, and that they breed fast enough
to maintain the abundance, and that they bite often enough to transmit
disease. And these are, after all, the vital facts.
NATURAL ENKMIES.
Mosquitoes, like most other insects, and, indeed, most of the lower
organisms, reproduce very rapidly and would, if unchecked, overrun
the earth in a very little while. But nature provides checks and counter-
checks for such rapid multiplication. Whether there are any creatures
that prey upon the eggs or not, it is certain that a large per cent, of
them never hatch. In the larval or wiggler stage they have many
enemies. Minnows eat them, the larvae of dragonflies and beetles eat
them, disease attacks them, fungi get on them and kill them ; they die
for lack of food, they sometimes eat one another, they get entangled in
threads of spirogyra or under floating leaves and drown. The water
dries up before they are grown and millions of them perish in this way.
Finally, when they are ready to emerge from the pupa, the cast-off
skin serving as a boat for the casting to take place in, frequently
capsizes and the mosquito dies at the very threshold of existence. And
those that do hatch successfully now have to take their chances among
dragon flies, bats, Hazards, toads, night hawks, and a host of other
enemies.
MOSQUITO CONTROL.
Suppose that some progressive energetic town desires to get rid
of mosquitoes, how will it go about it? Manifestly, the first thing is
to determine what the prevailing species are, and where they hreed.
The State Board of Health may lend assistance here. This determined,
it remains to control these breeding places. By far the greater number
will be found to be neglected vessels of water on private premises,
such as tanks, cisterns, rain-barrels, watering troughs, sagging gutters ;
even the water pitcher in the spare room may breed mosquitoes enough
to supply the whole household. Let the council make it the duty of
every citizen to keep his own premises clear of wigglers, imposing, if
necessary, a small fine for neglect of this duty, in order to make it
effective. Troughs and pitchers and vessels that can be emptied once
a week need that only. Cisterns and tanks can be screened so that the
mosquitoes can't get to them to lay their eggs. Or, they can be oiled.
(BO)
In addition to this, let every household, have its artificial breeding
place — a pail of water set in some shady place in the yard. Mosquitoes
will come to it to deposit their eggs, instead of going to some place
where they would be difficult to find or get at. These traps will catch
most of the eggs to be deposited about the place. And as they require
about ten days to come to maturity, the pails need only be emptied once
a week and refilled. But they serve a better purpose still than merely
an artificial breeding place. They will be a most potent factor in
education. They are so many aquaria where every man, woman and
child will acquire a practical knowledge of the breeding habits of
mosquitoes — will come to know the eggs, the larvae, pupae, the time
they require to hatch, the wherefore of exterminating them, and then,
CULEX P1PIENS. LINN. AFTER HOWARD. (FEMALE.)
instead of having a few enthusiastic workers, the whole town will be-
come enlisted and the mosquito is doomed.
Breeding places around town are to be controlled by the city author-
ities. Some places can be filled up. Others can be ditched. Fish can
be introduced into some, or duckweed, and so on. The ingenious
American will find ways and means if only he enlists in earnest.
To control the salt-marsh breeders is a state problem and can not
be discussed here. Nor does it concern places without the range of
their migration— say, 20 miles or more from the coast. Nor need it
deter any place from waging war against its local mosquitoes, thereby
getting rid of disease carriers.
^ORIQ^
Health ^feggBNotes
OFFICIAL BULLETIN
Published Monthly by the
STATE BOARD OF HEALTH
Subscription 50 Cents per Annum
Entered as Second Class Matter, April 20, i»io,
At the Postoffice at St. Augustine, Florida, Under the Act of July 18, 1894.
Vol. VIII May, 1913 No. 5 (££)
Hon. E. M. Hendry, President, Hon. H. L. Simpson, M. D„
Tampa, Fla. Hon. John G. Christopher, Pensacola, Fla.
Jacksonville, Fla.
EDITED BY
Joseph Y, Porter, M. D., Secretary and State Health Officer.
Hiram Byrd, M. D., Assistant State Health Officer.
EXECUTIVE OFFICE AND CENTRAL LABORATORY :
State Board of Health Building,
Springfield Boulevard,
Jacksonville.
BRANCH LABORATORIES I
State Board of Health Building
Florida Avenue and Constant Street, Tampa.
City Hall, Pensacola.
Sent to any address in the State for the asking.
If you receive it without asking, it means that someone else has requested
it for you.
When you change your address drop us a card.
When giving change of address, give both the old and the new.
Anything you want to know about the public health we will try to tell you.
Any information you want about communicable diseases of domestic animals
we will help you to get
Address communications to Jacksonville, Fla.
"Prejudice takes the place of reason and hatred warps the faculty of thought.'
(82)
LISTEN.
Would you keep well this summer, and for the matter of that, for
all time? Then you must pay due regard and obedience to Nature's
laws of rightful living. And by you, the Notes means anyone whose
eyes follow these lines. The laws of health are as inexorable as the
celestial or terrestial laws. They are unchangeable, and when a man
disobeys or violates one of these laws punishment follows, and the
severity is according to the degree of the offense. Intemperance in
either eating or drinking is oftentimes immediately followed by sick-
ness, and if the indignity to Nature is repeated then the consequences
are more serious, but perhaps not fatal. However if a dose of poison
is taken Nature is overwhelmed with the violence of the insult and
death results. So it is plain to see and to learn that to be healthy and
to keep healthy every one must keep a guard over themselves, both in
matters of diet as well as in maintaining an equable mental tempera-
ment. Some say "rather than to be constantly on the alert for causes
which may make me sick, I prefer to take chances," and it is this class
who fall victims to disease and oft repeated attacks, generally ending
up in chronic invalidism. The physical constitution of people differs
as do their mental traits. Some people are more easily fatigued, more
readily succumb to sudden shocks or nervous impressions, have to be
more careful in their eating, demand more rest, such as sleep, than
other people require, or is necessary to maintain a healthy equilibrium
of vital forces. Each one must study himself, watch the effect of
various diet and certain acts, and then profit by experience thus gained
to bring into harmony those conditions of body and mind which effect
a healthy state, a physical well being. It is a common error that many
fall into in supposing that sanitary science is difficult to understand,
or that there is a mystery about keeping well. 'Tis true that life itself
is a mystery, a great mystery, and that the students of the human body
are appalled every day when pondering over the delicate machinery of
the human frame, and see that each part fits so in harmony with every
other part, and must do so to keep up breathing, moving and thinking
in this wonderful construction of a Supreme Being, But the principles
of sanitation are so few and so simple, and more than that, have been
written and talked about so much that the person must be densely
ignorant, and unlettered, who does not know the necessity of pure air,
pure water, pure and wholesome food, in preserving the human health.
It is not absolutely essential that every one should have a knowledge
of bacteriology in order to understand why gormandizing is hurtful,
J
(83)
or that sleeping in a close room is injurious because of the contaminated
air which is breathed over and over again, or that if the body is not
sufficiently protected from the chill of cold, congestion of the internal
organs will probably take place, or on the other hand if the body is kept
too hot, and in profuse perspiration by heavy clothing, increased heart
action takes place, and depression of energy follows.
If individuals will only stop and think a little — reason the matte i
out, with cause and effect, it will not be a difficult problem to solve-,
this business of keeping well.
BRAINS VERSUS IDIOCY.
A man of intellect exercises that quality of mind which seeks to
understand proven facts and does not jump at conclusions or express
an opinion until all evidence has been carefully considered and the
argument both for and against has been minutely gone over in every
possible detail of disputation. A man of intellect is not swayed by
prejudice or bigotry or conceit. He is not self-opinionated, and above
ali else he is consistent in both his expressions on any given subject
as well as in his acts. He does not advocate one thing one day and
do another exactly opposite the other. In fine, a man of intellect is
a reasoning being, willing to be convinced, and yielding to those who
have made a special study of a subject, a superiority of knowledge in
any line of inquiry which he has not had either the opportunity of
gaining for himself or the desire to especially investigate. The coun-
terpart of the individual which is here described is an imbecile, an
idiot in general terms, whose gray matter is so small and so lacking
in quality that prejudice takes the place of reason and hatred warps
the faculty of thought.
These two types of human kind are found in every community,
in every State, and may be said to be the progressives and obstruc-
tionists of society. It is certainly refreshing and should be a matter
of great congratulation to the sanitarians of the United States to have
at the head of this great nation a man of intellect, a man who accepts
proven facts in sanitation and withal a man who will act upon his
conviction of what is right, and adopt measures for the preservation
of the public health which centuries have confirmed to be not only the
best but the only means of escaping contagion. When President
Wilson ordered that every member of the White House family should
be vaccinated because a servant employed lived elsewhere in the city
where a smallpox case had developed, he set an example to the antis
(M)
and to certain other people, supposedly high in the councils of the
nation, that was a sermon full of sound and thoughtful doctrine. Not
only did President Wilson give the order for every member of the
official family residing or employed in the White House to be vac-
cinated, but he did more. He showed his faith in the discovery of
Jenner, and bared his own arm to receive that protection against
smallpox which the experience of centuries teaches never fails. Mrs.
Wilson and the Misses Wilson, the press tells us, also were vaccinated.
There does not seem to have been any hesitation on the part of the
President as to what was the proper course to pursue, for his action
was prompt and decisive.
Health officers can now take courage and hope for that support
in national health legislation which a practical application of knowl-
edge of preventive measures on the part of the President shows thai:
he fully appreciates and has taken an active interest in promoting.
GOOD ADVICE.
The President of the State Board of Health, in his annual report
this year, to the Governor of Florida, says, among other things :
"Malaria is a mosquito carried disease. It could be eliminated
by getting rid of all mosquitoes. This is impossible. But malaria can
be reduced by preventing the mosquitoes from biting. This, too, is
only possible within certain limits. The mosquito that transmits ma-
laria bites, as I understand, only at night. Then it follows that, by
sleeping under mosquito nets and in screened houses, malaria-carrying
insects can be kept out. This will prevent malaria. But here again,
no law or organization can make one do so against his will ; here again
it is seen that the matter of protection against malaria is also a matter
of individual responsibility.
"Typhoid fever, on the contrary, shifts the burden. Here it is not
the individual so much at fault as the community. Typhoid fever in
this State is largely fly-borne. But the flies themselves are innocent,
except when they are permitted access to typhoid excreta. The preva-
lence of typhoid fever, therefore, resolves itself into one of sewage
disposal. That is the work of the community. No community can
have a low typhoid rate till it addresses itself seriously to the matter.
We have assurance, however, that any municipality that earnestly
undertakes it, can do so with the full certainty that the "goods can
be delivered.' Public opinion is beginning to hold the municipality
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culpable that fails to provide protection to its citizens against this dis-
ease.
"The glanders law is defective. In a general way it provides, when-
ever an animal develops glanders in the State, and it is so diagnosed
by the State Board of Health, the animal is to be destroyed by the
owner and paid for by the State. It was recognized that this would
put a premium on the practice of unscrupulous horse dealers bringing
glandered animals into the State, having them diagnosed and killed
and paid for. But the law tries to make ample provision against this
by requiring, as a pre-requisite to payment, that the animal shall
have been in the State a year when the disease is developed. But
oftentimes the disease, although contracted elsewhere than in Florida,
does not develop for two or more years, and so the law is defective in
this particular. It was also recognized that the early diagnosis of
gianders is imperative, and in order to have any suspicious trouble
early reported to the State Board of Health, another pre-requisite is
that no owner should be paid for the loss of more than ten animals in
any one year.
"The law has been operative for four years, and has been scrupu-
lously followed by the State Board of Health. But the legislature has
twice enacted special legislation not in harmony with the law. In
one instance more than ten animals were paid for, and in the other
animals were paid for that had not been in the State a year.
"The law is not quite clear on that point. As a pre-requisite to
paying for condemned animals they are to be appraised. The law
specifies that the condition of the animal at the time of the appraise-
ment is to be taken into account by the appraisers. Some appraisers
take it to mean that the animal is to be appraised as it would be without
the disease — that is, its worth without glanders; others, that it is to
be appraised as glandered. In the latter case, it is manifestly value-
less, for it is to be killed. If it is appraised as valueless, there is no
reimbursement to the owner. This has occurred once. A very poor
widow lost an animal from glanders, and could not recover a cent for
it, while in all other instances the animals have been appraised at
something, usually $75.00, which is the maximum to be paid. Here
again, the legislature has enacted special legislation. In one instance
the animals were all appraised at their value with glanders subtracted,
and the owners were reimbursed at the appraisement value, although
they had previously been paid $75.00 as the law provides. It is hardly
fair to the State Board of Health to be charged with the administra-
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tion of a law that is so defective that one person will be reimbursed
for a glandered animal and another not. Nor is it fair to the Board
or to the public, that of all those that lose animals and are duly re-
imbursed according to law, certain ones should be singled out by the
legislature for special reimbursement while others are ignored. It is
hoped that a sense of justice to the people and fairness to the Board
will prompt the legislature to remedy the defect in the law so that it
can be administered to all alike."
The President of the Board strikes at the root of defective legis-
lation when he comments on the free distribution of hog cholera serum.
Listen to what he says :
"The free distribution of hog cholera serum by the Board was
provided for by the last legislature. Within certain limits hog cholera
serum is a bonanza to stock raisers. But the rationale of it is so in-
tricate, so difficult to understand, and so more than difficult to apply
with accuracy, except by one trained especially for it, that it is not an
economic procedure to send it out free to all who ask. Under the
present law, the Board has no choice but to send it to all who ask. I
understand it is requested under all sorts of misunderstandings. For
instance, sickness gets among a man's hogs, and he thinks it is cholera
and asks for serum. It is found to be lung worms instead of cholera.
The serum is used, and is more than wasted. It is wasted because it
does no good. It is worse than wasted because the owner thinks his
hogs are afterward immune to cholera when they are not. Then
when true cholera comes, he makes no provision against it, because
he thinks they are immune. More than that, he thinks the serum is
a failure, and disparages its use. Then there are other errors — a man
has a herd of hogs that are doing well ; he requests the State Board
of Health to come down and give them the serum, thinking it like
some patent medicine and good for everything. Again, a man will
order serum and then not use it. On one occasion a man asked for
1,000 c. c. (Twenty dollars' worth.) It was promptly sent with full
instructions. Six months later the Assistant Veterinarian was in a
barber shop and saw the bottle setting on a shelf unopened. Upon in-
quiry, he was told by the barber that the man paid a barber bill with
it. Again, people use it, and make no report on it. They are written
for reports again and again, and only a small per cent report. Nearly
six thousand dollars* worth of the serum sent out during the year has
had no report made on it. From all of which it will be seen that
there are so many places where there is an unavoidable leakage, that
(8?)
to send it out free is not an economical procedure. Whatever is gained
where it is accurately administered, is lost by errors, in other places.
"It is, therefore, hoped that you will impress upon the legislature
the necessity of revising the law so as to subserve the purpose for
which it is intended. This can readily be done; the only thing neces-
sary is to so revise the law as to have the serum furnished, not free,
but at actual cost, or even at fifty per cent of the cost, the State Board
of Health paying half; anything to get it off the 'free list' so that
some check can be had on it."
The report is as full of sound business judgment and reasoning
as a Florida pecan is full of wholesome and toothsome meat. If you
have not seen it, write for a copy. It is yours for the asking.
AS OTHERS SEE.
It is profitable at all times to learn from others, and what our
neighbors say or think on the problems of the day oftentimes make
a deeper impression and are of more lasting benefit than the expres-
sions coming from the members of our own family. The legislature
of Pennsylvania last year authorized and required the Governor of
that State to appoint a commission to inquire into vaccination, and
report upon its merits and demerits. The commission, the act
stated, was to consist of two men known to be in favor of vaccination,
two men known to oppose it, and three neutrals. The following, taken
from the report of the "Vaccination Commission of Pennsylvania," a
document recently received, presents the views which the State Board
of Health of Florida has for a long time entertained, and tells what
a careful investigation, unbiased and unprejudiced, has gathered from
a vast amount of information, which has been obtained in a most
careful and painstaking way :
"In the days when smallpox inoculation was practiced the pro-
tective value of vaccination appears to have been indisputably proven
on many occasions and in many lands, by the so-called 'variolous test."
Persons who had been vaccinated were subsequently inoculated with
smallpox with negative results, thus evidencing the fact that vaccina-
tion protected against smallpox.
"One of the most conclusive of these tests was that carried out on
Noddle Island, Boston, in 1802. The plan of the experiment pro-
posed was published in the newspapers for the consideration of the
public. A small building was erected on Noddle Island and on August
16th, 1802, the experiment was begun. Nineteen boys who had been
vaccinated with cowpox were later inoculated with fresh smallpox
(ss)
virus. At the same time, in the same rooms with the same virus, two
previously unvaccinated boys were inoculated with smallpox. These
two subjects contracted smallpox, one having 500 pustules on the body
and the other 150. On the other hand, the nineteen children previous-
ly vaccinated developed neither fever nor eruption, but remained per-
fectly well. They were a second time inoculated with the material
from the two boys just referred to, but again resisted the smallpox
infection. Furthermore, 'they all remained together with the smallpox
lads, in the same house, in the same room, and often in the same beds,
without producing the least appearance of the smallpox.'
"Each of the children was examined by eleven eminent physicians
who were invited to be present, and 'who were individually convinced
from the inspection of their arms, their perfect state of health, and
exemption from every kind of eruption on their bodies that the cow-
pox prevented their taking the smallpox.'
"This test appears to us to be the most conclusive experiment of
the kind ever undertaken.
"Dr. Charles Creighton, of England, an anti-vaccinist witness be-
fore the Commission, would not admit the validity of this test, stating
that he doubted the 'logical capacity and critical sincerity' of these
eleven physicians. But this experiment was made in the presence
of five laymen who constituted the Board of Health, and these non-
medical witnesses corroborated in detail every statement in the report
of the physicians.
"They conclude : 'Having daily visited the hospital ourselves, and
made the most critical observations and inquiries' * * * we
'therefore are confident in affirming that the cowpox is a complete
preventive against all of the effects of the smallpox upon the human
system.' "
The State Board of Health will furnish full information on small-
pox and vaccination to those who desire it, and places gratuitous vac-
cination within reach of every one. The information that the Board
has to offer aside from that gleaned from the literature, is an experi-
ence covering 25 years, in which it has had the management of 15,000
cases of smallpox and has done approximately 300,000 vaccinations.
Whether it is qualified to speak with authority on the subject of small-
pox and vaccination, let those answer who are interested.
It might be said, in this connection, that there are certain things
to be said against vaccination, but it is the opinion of this office that
the things in its favor far outweigh those against it, and should re-
ceive paramount consideration. However, the Board does not, nor
does it have any desire, to enforce compulsory vaccination, and agrees
with the Commission mentioned above that the statute in that State
requiring vaccination as a precedent to school admission, constitutes
(89)
the most important barrier against widespread epidemic of smallpox
(such as was experienced in Jacksonville two years ago, when the
school board withdrew the rule requiring vaccination as a prerequisite
for entrance into public schools, and in Pensacola last year). The
Board will furnish information true and unbiased, and then the in-
dividual must be the arbitrator of his own fate.
ANOTHER OBJECT LESSON.
A remarkable demonstration of the value of vaccination recently
occurred near Dundee, 111. Miss Helm, teacher in a country school,
went to friends in Minnesota for a visit during the Christmas holidays.
She returned January 6, 1913, and resumed her teaching. Children
from seven families attended her school. On January 13th, Miss
Helm was taken sick with smallpox ; she had never been vaccinated.
On February 1st Miss Helm's mother came down with smallpox ;
mother was never vaccinated, father had been vaccinated and remained
well. On February 5th two of her pupils in the Fritz family came
down with smallpox ; they had never been vaccinated. All other mem-
bers of the Fritz family had been previously vaccinated and remained
well. On the same date two children in each of the Frink and Coats
families came down with smallpox ; never vaccinated. All other mem-
bers of these families had been vaccinated and remained well. On
February 12th exactly the same condition was repeated in the Price
family. This accounted for four families. The pupils from the re-
maining three families had all been vaccinated and none contracted
the disease. — Buffalo Sanitary Bulletin,
"THE HALL MARK OF IGNORANCE."
"I don't blame my mother, because doubtless she thought she was
protecting me when she would not have me vaccinated. Many a time
I have heard her say that virus was filthy and would give me scrofula.
I knew no better and grew up to manhood unvaccinated. While I was
on the road, ten years ago, I stopped over night in a town where there
was an epidemic of so-called 'chicken pox,' very mild, they said, and
harmless. I went home and in two weeks developed smallpox in its
virulent form. For three weeks I suffered the tortures of perdition,
and when I was well again my face was fearfully pitted, as you see.
The scars are bad enough, heaven knows, for they disfigure me for
life, but I hate them still more for another reason. Why? Because
(90)
they brand me for life with the hall-mark of ignorance and useless
suffering."— Virginia Health Almanac.
DR. OSLER'S CHALLENGE TO THE
ANTI- VACCINATIONIST.
"A great deal if literature has been distributed casting discredit
upon the value of vaccination in the prevention of smallpox. I do not
see how anyone who has gone through epidemics as I have, or who is
familiar with the history of the subject, and who has any capacity
left for clear judgment, can doubt its value. Some months ago I was
twitted by the editor of the Journal of the Anti-vaccination League
for a 'curious silence' on this subject. I would like to issue a Mount-
Carmel-like challenge to any ten unvaccinated priests of Baal. I will
go into the next severe epidemic with ten selected, vaccinated persons
and ten selected unvaccinated persons — I should prefer to choose the
latter: three members of parliament, three anti-vaccination doctors, if
they could be found, and four ant i -vaccination propagandists. And I
will make this promise — -neither to jeer nor jibe when they catch the
disease, but to look after them as brothers, and for the four or five
who are certain to die I will try to arrange the funerals with all the
pomp and ceremony of an anti-vaccination demonstration."— A merican
Magazine.
The following is an expression of opinion of Dr. Watson, of New
Hampshire, regarding smallpox and vaccination :
"The State has been obliged to be at an expense of nearly $3,000
during the two years on account of smallpox. The little town of
Jackson was put to an expense of over $2,200 on account of an out-
break of smallpox in a lumber camp in that town. We are probably
well within bounds in stating that smallpox during the two-year period
has entailed an expense upon the State and the towns of not less than
$10,000 — all of which might have been avoided through vaccination.
"Every person has it within his own power to protect himself from
smallpox, and it is a question how much longer quarantine will be
maintained against this disease. It has already been abandoned in
some States. It would seem to be not unreasonable to place the re-
(91)
sponsibility of protection upon the individual, for in vaccination he
has absolute protection."
A successfully vaccinated person who, after exposure to smallpox,.
is re-vaccinated, should never be quarantined ; he should be allowed to-
continue at his work, but be kept under supervision to guard against
his developing smallpox, a thing that will rarely happen. To place
such a subject in quarantine, thereby making him a charge upon the
taxpayer, is frequently an abuse of power, an exhibition of ignorance
of the protective power of vaccination or an unwillingness to accept
the results of the experience and studies of other men. It is also an
incentive to conceal those sick of such diseases, and is as much to be
censured as is a case of highway robbery. The city may furnish fuel
and a limited amount of provisions ; occasionally it will furnish cloth-
ing and other articles, but it does not pay the house rent or the ser-
vant's hire. The vaccinated unquarantined man will be a material aid
in the management of smallpox.— The Virginia Medical Semi-Monthly.
THE STUDENT'S HEALTH CREED.
I believe my body and good health are sacred. If I am sick it will
very probably be because I have violated some one or more of na-
ture's laws of health.
I will study nature's laws of. health and will obey them for my
own sake.
I will not suck my fingers, or pick my nose or wipe my nose on
my hand or sleeve, for these practices are unsanitary and very im-
polite.
I will not wet my fingers in my mouth when turning the leaves of
books.
I will not put pencils in my mouth nor wet them with my lips.
I will not put pins or money in my mouth.
I will not buy nor use chewing gum nor buy and eat cheap candies.
I will only use my mouth for eating good plain food, drinking pure
water and milk, and for saying good and kind words.
I will always chew my food thoroughly, and never drink whiskey
or wine.
I will strive against the habit of "clearing my throat" because it is
nearly always unnecessary, and may be disagreeable to others.
(92)
1 will not cough or sneeze without turning ray face and holding a
piece of paper or handkerchief before my mouth. Polite people never
cough in public if they can prevent it.
I will not paint, print, or carve any vulgar and obscene words or
pictures in any of the houses.
I will keep my face, hands and finger nails as clean as possible.
I will not spit on floors, stairways or sidewalks, and will try not
to . spit at all ; ladies and gentlemen do not spit.
I will wash my mouth every morning on getting up and at night
on going to bed, and will use a tooth brush if I can get one.
I will be clean in body, clean in mind and avoid all habits that may
give offense to others.
I will get all the fresh air I can and will open wide my bedroom
windows when I go to bed.
Name of student.
— Department of Health, Clinton County, Indiana.
STATISTICS.
SMALLPOX,
During April, 1913, 113 cases of smallpox were reported from the
following counties (2,265 points vaccine were distributed) :
Alachua 2
Bradford 9
Citrus 1
Dade - *
Duval 19
Escambia 59
Jefferson 2
Levy - 3
Manatee - 3
Marion 2
Santa Rosa t
St. Tohns 5
Total. April llM
Total reported cases, 1913 737
(93)
RABIES.
During April, 1913, anti-rabic treatment was administered in the
following counties:
DeSoto 2
Duval 8
Hillsboro 7
Pasco 2
Polk 1
Total, April 20
Total number persons treated, 1913 5fl
GLANDERS.
During April, 1913, glanders was found in the State as follows:
Duval County 2 cases
Total cases glanders, 1913 ,10 cases
hog cholera (Distribution of Serum).
Amount hog cholera serum distributed, April 27,500 c. c
Amount hog cholera serum reported administered by agents, April , . . 8,865 c. c.
Number hogs treated in April 456
Total weight hogs treated, pounds 27,850
Total number agents appointed, April 43
Total number agents appointed 158
TICK ERADICATION.
During April the following counties were visited by Tick Eradica-
tion Agents of the State Board of Health: Columbia, DeSoto, Hills-
boro, Lee, Polk and Osceola.
Clubs were organized in April in the following counties : Columbia,
Polk, DeSoto, Lee and Osceola.
In April cattle dipping vats were built in the following counties :
Hillsboro 1
Alachua , . . . 3
Leon I
Marion 2
Duval 1
Total number vats constructed, April 8
Total number vats constructed to April 30 9
During the month of April public demonstration of dipping cattle
was held in Florida at Tallahassee, Leon County.
CMj)
PUBLICATIONS.
During April two publications were issued by the State Board of
Health for distribution, as follows :
Publication No. 104, Hookworm.
Publication No. 105", Malaria.
Total pieces literature distributed in April 1,496
SPECIMEN EXAMINATION, BACTERIOLOGICAL LABORATORIES.
Jacksonville Tampa Pensacola
Animal Parasites 234 110 28
Diphtheria 81 54 8
Gonorrhea 41 23 50
Malaria 183 231 25
Pathological 12 19 3
Rabid Dogs 15 (1 cow)
Tuberculosis 1G3 73 42
Typhoid Fever ..114 146 12
Water (for Sewage Contamination) 4 2
Miscellaneous 2M • t8 39
Totals 874 680 209
Total specimens examined by State Board of Health Laboratories, April,
1913, 1,763.
INGERSOLL'S REPLY.
A young man who sought a clerkship in one of the departments at
Washington, once asked the late Robert G. Ingersoll for his endorse-
ment and this was Ingersoll's reply:
"Young man, I would rather have forty acres of land, with a log
cabin on it and the woman I love in the cabin — with a little grassy,
winding path leading down to the spring where the water gurgles from
the lips of the earth, whistiing day and night to the white pebbles a
perpetual poem — with hollyhocks growing at the corner of the house,
and morning glories blooming over the low thatched door — with lattice
work over the windows so that the sunlight would fall checkered on
the dimpled baby in the cradle— and birds, like songs with wings hov-
ering in the summer air— than be clerk of any government on earth."
In Siam, those who die of smallpox are refused cremation until
after they have been buried awhile, because they are said to "lack
merit" — another way of saying "because they didn't get vaccinated."
That would have saved them both from smallpox and from the humilia-
tion of an improper funeral.
A bird dog belonging to a man in Mulvane disappeared. The
owner put this ad. in the paper and insisted that it be printed exactly
as he wrote it:
"Lost or run away — one livver culered burd dog, called Jim. Will
show signs of hyderfobby in about three days."
The dog came home the following day.
Any closet is sanitary that is fly proof.
^VORI^
Health
Notes
OFFICIAL BULLETIN
Published Monthly by the
STATE BOARD OF HEALTH
Subscription 50 cents per Annum
Entered as Second Class Matter, April 20, 1910,
At the Postoffice at St. Augustjne, Florjoa, Under the Act of July 16, 1864.
Vol. VIII
June, 1913
No. 6 (
New \
Seri™/
Hon, Frank J. Fearnside, President, Hon*. S. R. Mallorv Kennedy, M. D.,
Palatka, Fla. Pensacola, Fla.
Hon. C. G. Mem mincer.
Lakeland, Fla.
edited by
Joseph Y. Porter, M. D., Secretary and State Health Officer.
Hiram Byrd, M. D., Assistant State Health Officer.
EXECUTIVE office and central laboratory :
State Board of Health Building,
Springfield Boulevard,
Jacksonville.
BRANCH LABORATORIES !
State Board of Health Building
Florida Avenue and Constant Street, Tampa.
City Hall, Pensacola.
Sent to any address in the State for the asking.
If you receive it without asking, it means that someone else has requested
it for you.
When you change your address drop us a card.
When giving change of address, give both the old and the new.
Anything you want to know about the public health we will try to tel! yon.
Any information you want about communicable diseases of domestic animals
we will help you to get.
Address communications to Jacksonville, Fla,
How like the leper, with his own sad cry
Enforcing his own solitude, it tolls!
That lonely hell set in the rushing shoals,
To worn us from the place of jeopardy! .
— Charles (Tennyson) Turner.
■ (98)
LEPROSY.
By Dr. Hiram Byrd, Assistant State Health Officer, Jacksonville, Fla.
[Read before ttie Annua] Meeting of State and Municipal Health Officers of
Georgia, at SsTannah, April 15, 1913. Published In Journal of The Medical Associa-
tion of Georgia, June, 1013.]
In Munich, Germany, there is a painting, now 397 years old, by the
celebrated artist, Hans Holbein, It represents Saint Elizabeth giving
bread and wine to a group of prostrate lepers. That picture connects
the leprosy of the middle ages with leprosy as we know it today. The
disease represented by the painting is unmistakable. Virchow does not
doubt that Holbein studied leprosy among the hospitals at Augsburg,
and that this painting was made from life.
Leprosy is the oldest disease of which we have any definite history.
Its original home is lost in the misty records of the past. It certainly
prevailed in Egypt, for when the Jews left there it undoubtedly was
endemic among them. The subsequent descriptions by Moses and the
institution of methods of segregation show that he was well acquainted
with it, but that the methods of diagnosis at that time were not suf-
ficiently discriminating and that they included several other diseases,
one of which was probably vitiligo. Some think that Job's affliction
was leprosy.
Just wJien leprosy was introduced into Europe is a matter of con-
siderable doubt, but it was certainly at a very early date. The Lom-
bard King, Rothar, in the seventh century made laws regulating the
marriage of lepers, and so did Charlemagne. But it was not until the
Crusades, about the twelfth century, that it became widespread. First
appearing in Italy, it spread from there over entire Europe. For a
period of two or three hundred years it was a veritable curse. About
the fifteenth century every town, even of moderate size, had a leper
hospital. It has been estimated that there were as many as nineteen
thousand leper hospitals in Europe at once. France alone had over
two thousand. In the southern part of Europe these leper hospitals
were usually of some religious character and were dedicated to San
Lazaro, whereas in the northern part they were more secular and most
of them dedicated to Saint George. Finally, toward the latter part of
the sixteenth or seventeenth centuries, leprosy slowly declined. The
last case seems to have died in Shetland Islands about 1741.
DISTRIBUTION.
At the present time leprosy is distributed, more or less, all over the
world. Its greatest prevalence is in southern Asia. Its least prevalence
seems to be in North America, Northern Europe and Northern Asia,
but, even where it is least prevalent, there is here and there an occasional
case, or even a leper colony. At the International Congress on Leprosy,
at Bergen, Norway, in 1909, there were reported nearly two hundred
thousand officially recognized cases in the world. Of these, India has
practically half: Japan about 40,000; Java, 15,000* the Argentine
Republic, 12,000;. Indo-China, 10,000; United States of Columbia,
4,000, while America, together with her island possessions, has a little
over 3,000. The mainland of America had only 146 reported, whereas
the Hawaiian Islands had 764 ; Porto Rico, 17 ; Guam, 19 ; Canal Zone,
7, and the Philippine Islands, 2,330. In the United States proper there
is no way of knowing just how many there are, but there seems to be
three or four centers wherein they have more than elsewhere.
In 1909 the late Walter R. Erinckerhoff, of the Public Health
Service, made a report upon leprosy in the United States. He collected
a total of 139 officially recognized cases. Of these Louisiana had 50 ;
Florida, 20; California, 20; Minnesota, lfi; Texas, 12; Massachusetts,
8 ; New York City, 4 ; South Carolina, 3 ; Washington, Wisconsin, New
Jersey, Missouri and District of Columbia each 1. This report is
evidently very incomplete, as any report upon leprosy must of neces-
sity be. Erinckerhoff himself, thinks that there are at least twice as
many cases as have official recognition. But the distribution is, never-
theless, significant. There are what might be termed centers, the most
important of which is in Louisiana. This is easily accounted for by
the fact that Louisiana was largely colonized from France, at a time
when France still had a considerable leper population. Florida has a
considerable Cuban population, particularly at the coast places, and
Cuba has 1,000 to 1,200 lepers now. California has a considerable
Japanese population, and Japan, we remember, has some 40,000 officially
recognized lepers. Minnesota has a large Norwegian population, and
Norway is still a leper center. It is among the Norwegians that the
disease is mostly prevalent in Minnesota.
DIAGNOSIS.
From a public health standpoint the two most important considera-
tions are diagnosis and management.
(100)
Leprosy, like smallpox, is very easily diagnosed when a man who is
familiar with the disease encounters a typical case, but a large number
of cases are not typical. In San Lazaro Hospital, Havana, the author
saw a number of cases which had he met them on the street he never
would have suspected they were lepers. In Hawaii, where the disease
is fairly prevalent and where the population in general is so familiar
with it that the layman knows it as w r ell as our lay population knows
tuberculosis, even there, Brinckerhoff believes that the average leper is
overlooked four years before a diagnosis is finally made.
In the United States proper there are approximately one thousand
times as many physicians as there are lepers. Consequently a large
majority of them have never and will never see a leper during their
entire professional career. Even those physicians located at the most
leprous centers, but who do not go abroad to study the disease, will
rarely in life see more than a score or two of cases. No wonder a
contention can arise about the diagnosis of the disease.
In the present day no one undertakes to make a definite diagnosis
of leprosy without finding the lepra bacillus, so that after all the
microscope is the final judge in the case. But before it can come to the
microscope some symptoms must develop which arrest the physician's
attention and cause him to suspect leprosy. It is only that group of
symptoms which will be considered in this connect ion— those symptoms
which appear earliest and which are earliest calculated to- arouse
suspicion on the part of the physician and to lead to microscopical
examination.
Brinckerhoff secured detailed histories of twenty-one cases which
are about as accurate as one can ever hope to get, since the disease is
practically always some months or years old before a final diagnosis is
made and before an onset history is sought.
Of these twenty-one cases the first symptom noticed was, in twelve
instances, "spots" on various parts of the body, mostly the face. Some
of the spots were white, but most of them were described by the
patients as red. These spots varied in size from a flea bite to as large
or larger than a dollar. Four of the twenty-one patients first noted
macules. These were variously located. One experienced difficulty in
breathing through his nose five years before the spots appeared on his
body. One had the red spots come in his face and experienced a
numbness of the hands, about the same time, while one had a "cold"
(101)
in the head which was followed by nodules in the face. In a leprous
community these spots are sufficient to at once arrest attention, but
elsewhere they won Id more than likely be passed as a simple urticaria.
A leper that came under the author's observation seems to have first
developed some face disturbance, which was explained as due to a
powder burn. Another one had an attack of fever, which may or may
not have been caused by leprosy, after which he experienced a thicken-
ing of his nose with more or less obstructed breathing. Following
this erythematous patches appeared in his face, and later over his body.
In the presence of known leprosy, the foregoing symptoms are quite
sufficient to attract attention, but fn its absence, and especially where
the laity and even the physicians are not familiar with the disease, it
usually has to progress much further before serious attention is paid
to it. Further progress is manifested in most cases by these spots on
the face or body, as the case may be, getting a little more pronounced
and more prominent by reason of becoming pigmented. At the same
time the ears are likely to take on a patulous consistency and later to
become very large, tight and cold.
I once had the pleasure of being present when the commission for
infectious diseases in Havana passed on a case of suspected leprosy.
This was the condition of the patient in question. It had progressed to
this point without previously having attracted attention, although in a
town where there is a leper hospital with about one hundred and
seventy-five inmates and where all of the physicians are acquainted with
the disease. The patient had been working in a meat shop up to the
very day that he was apprehended and brought before the commission.
MICROSCOPICAL DIAGNOSIS.
As before stated the microscope must be the supreme court in these
cases. In Havana, in Hawaii and everywhere else, so far as I know,
no case is finally diagnosed without bacteriological confirmation. The
simplest method of examination for the lepra bacilli consists of making
smears from the nasal secretions and will usually; though not always,
yield positive results whenever there is a nasal ulcer. When a case is
suspected and the nasal swab does not show the lepra bacilli other
methods have to be resorted to. It should be remembered that the lepra
bacilli in the tissues occupy the lymph spaces. They rarely find their
way into the blood, except by accident, but they fill the lymph space
with such numbers as to produce a sort of lymph stasis, particularly
(102)
in the lobe of the ear, and it is from this point that they are most easily
obtained. The lobe may be caught up between the arms of a pair of
forceps and pressure exerted until the crest of the fold becomes
blanched. Now a little incision can be made through this and clear
lymph will exude. A slide is applied to this and a drop secured on
the middle of the slide and allowed to dry. When this is stained after
the manner of staining the tubercle bacilli, the organisms will be found
frequently in immense numbers. (Dr. Hanson and I have made a
number of slides after this method which I wish to present with our
compliments to the gentlemen present, especially those that are more
interested in the bacteriological side of medicine.) When the lobe of
the ear is not affected, a hyperesthetic or anesthetic spot on the body
may be chosen and the skin pinched up in the same way, and the
incision made through the crest of the fold. The results will be just
the same.
This technic is used almost exclusively in Havana and, as I under-
stand, originated there. It is certainly the simplest and probably the
best method yet devised for finding the lepra bacilli. The more usual
technic is to select an anesthetic spot or a nodule, as the case may be,
and cut out a tiny portion of the tissue. In Honolulu a safety razor
blade is used for this purpose. It is then ground in a mortar, put on
a slide and stained as for tubercle bacilli.
ETIOLOGY AND TRANSMISSION.
Very young persons rarely have leprosy, very old rarely have
active cases. The majority of the cases occur between fifteen and
thirty years. Men have it more than women. About two-thirds of a
leper population will he found to be men. That the disease runs in
families is well known. It has accordingly been held that it is in-
herited. A successful contradiction of this is found in Molokai. There
they have a colony of six or seven hundred lepers. Children are
frequently born of leper parents. They are immediately taken away
from the parents and transferred to an orphan asylum in Honolulu.
They have two of these asylums, one for the boys and one for the
girls. They have some forty children in each. Dr. Pratt assured me
that in no instance as yet have they had one of these children later
develop leprosy. The conviction is accordingly forced upon us that
leprosy is not inherited. Another very general truth must be recog-
nized. Leprosy does not develop in a country zvhere there is no pre-
(103)
existing leprosy. Just how it is transmitted from person to person,
though, is not definitely known. The prevailing opinion is that it is
contagious, but not contagious in the sense that smallpox or scarlet
fever is, but a contagion of a low order— one more like the contagious-
ness of tuberculosis, but still lower. It is a well known fact that per-
sons frequently live in close contact with lepers for years and years
without ever contracting the disease. Again referring to Molokai, in
that colony they had eight or nine hundred lepers until recently when
the number has gradually become reduced to about six hundred. They
have something like one hundred helpers, not one of whom has ever
contracted leprosy there since Father Damien died of it in the eighties.
This leper colony in Molokai is a little social community unto itself.
The lepers have their sports and come to enjoy life perhaps as much
as most other people. While the authorities are now endeavoring to
prohibit multiplication of lepers, formerly marriage was common in the
island. Leprous and non-leprous individuals frequently married. One
woman is reported to have had five leprous husbands, and borne child-
ren by them, and never to have contracted the disease.
San Lazaro Hospital in Havana is in charge of the Sisters of Mercy,
not one of whom has ever contracted the disease.
Facts like these have led people to seriously doubt its contagious-
ness. But on the other hand if we assume that leprosy is contagious,
and of a very low order of contagion, it will be consistent with every
known fact, biologically, epidemiologically and otherwise, concerning
the disease. Such an assumption would make a person who lives with
leprosy take a certain risk of getting it, but that risk would be, to say
the least, very minimal. This is the view held by the leading leprol-
ogists of the world at the present time.
BACTERIOLOGY.
Just after Louis Pasteur had demonstrated the fallacy of spontan-
eous generation, and had shown that fermentation is a living process,
and had found that the disease, chicken cholera, is due to a living germ,
and had demonstrated that the silk worm disease, flacherie and pebrine,
were due to living organisms — just when people were beginning to
suspect that most or all of the diseases which we know as contagious
or infectious, were living process — a Scandanavian, Hansen, found in
the tissues of a person suffering from leprosy an acid-fast organism
(104)
which he named the bacillus leprae, and which has since been univer-
sally accepted as the specific cause of this disease.
The bacillus leprae belongs to a large group of oigamsms known
as the acid- fast group of which there are several well-known members
that are pathogenic and several others that are innocent.
Among the pathogenic members of this group may be mentioned
the bacillus of tuberculosis with all its varieties, the bacillus of leprosy
and the bacillus of rat leprosy; and among the innocent members, the
smegma bacillus and the hay bacillus.
Most or all of these can be grown in artificial culture media with-
out difficulty, but until very recent times the lepra bacillus has refused
to grow except in the human body. Many attempts to grow this
organism in vitro by many bacteriologists have utterly failed. It was
not until 1901 that Kedrowski cultivated an organism from leprous
tissue which he believed was the lepra bacillus, although it was not
acid-fast. He found that after he injected it into laboratory animals
and let it remain a few weeks it became acid-fast. He arrived at the
conclusion that the lepra bacillus was a pleomorphic organism. Four
years later Professor Deycke Pasha, in Constantinople, took leprous
nodules, transferred them to a normal salt solution and let them grow
at incubator temperature for a period of six weeks, when he found that
he had a profuse growth of a streptothrix which he called Strepto-
thrix leproides. Another four years elapsed when Clegg, in Manilla,
announced that he had been able to cultivate an acid-fast bacillus
from leprous tissue by growing it in the presence of an amoeba with
its symbiont, the cholera bacillus. He subsequently obtained a pure
culture of this acid-fast bacillus by heating to sixty degrees for thirty
minutes to kill the symbionts. Clegg's work was subsequently con-
firmed by Brtnckerhoff and Currie, in Honolulu, as well as several
other observers. More recently still Duval, of New Orleans, and his
co-workers report that they have been able to grow bacilli from leprous
tissue and, what is more, to differentiate them into two or three kinds.
He lays particular stress upon two varieties, one of which is chromo-
genic and the other non-chromogenic. From all of which it would
seem that about four distinct varieties of organisms have been obtained
from leprous tissue, two of which are non-acid- fast and two acid- fast.
Of the two non -acid-fast organisms one is a diphtheroid (Kedrowski)
and the other a streptothrix (Deycke). Of the acid-fast one is chromo-
(105)
genie (Clegg) and the other non-chromogenic (Duval). Whether
these four represent various forms of a pleomorphic organism is yet
to be determined.
SPECIFIC THERAPY. *
Two discoveries have combined to inspire the medical world with
many brilliant hopes, some of which have been destined to meet sore
disappointment. One was the discovery of antitoxin for diphtheria,
the chemical nature of which, though not understood, is highly specific
and the other is the specific reaction of tuberculin in persons suffering
from tuberculosis. These have led the world in untiring zest to seek
a specific for most or all of the more serious communicable diseases,
and particularly those diseases in which the specific cause is known.
Accordingly leprosy was among the first to entice workers to seek for
a cure. A large number of substances, chemical and bacteriological,
have accordingly been tried out. Danielssen, Goldschmidt, Truehart
and others have treated leprosy with tuberculin, the rationale of which
was based upon the fact that the lepra bacillus is morphologically and
tinctorially closely allied to the tubercle bacillus. It has been found that
tuberculin does give a reaction, that is to say, its injection makes the
patient temporarily worse. Potassium iodid has been used in the same
way, and for no other reason than after its administration the patients
frequently show a reaction. Carrasquilla claimed to have found a
specific for leprosy in what is known as Carrasquilla's serum. This
was prepared simply by taking the serum of a young, vigorous person
suffering from leprosy and using it as other sera are used. Babes
immunized animals with avian tuberculosis and injected their serum
into lepers.
There is a belief in Brazil that if a leper gets bitten by a rattlesnake
he will either die of snake bite or recover from leprosy. Marcoudes
de Moura accordingly used rattlesnake venom in the treatment of
leprosy. Following this Dr. Deyer, of New Orleans, used Clamett's
anti-venin and Rost, in 1905, used Ieprolin which was prepared from
culture of the lepra bacillus, as tuberculin is prepared from the cultures
of the tubercle bacillus. About this time Professor Deycke took large
quantities of the streptothrix leprodies which he had grown in salt
solution and injected into leprous patients and got a reaction, where-
upon he ground up the streptothrix and treated it with ether and
separated it into a fatty and non-fatty portion. The fatty portion he
(108)
gave the trade name of Nastin, which has been tried out in various
parts of the world but with indifferent success.
Gilchrist, in the Philippines, used the X-ray upon lepers. The
ingenious theory underlying this was that the X-ray would kill the
lepra bacilli near the surface and that they in turn would be absorbed
and act as a vaccine to increase the immunity of the patient.
Quite recent developments in cultures of the bacilli of leprosy in
vitro lead us to expect that the greatest possible use will be made of
these developments, and to hope that a therapeutic agent of unques-
tioned value may yet be found, for it must be acknowledged that up
to the present time the therapeutic treatment of leprosy is little if any
more advanced than it was one thousand years ago.
PROGNOSIS.
Although the treatment of leprosy is as yet unsatisfactory, it is to
be admitted that a certain number of cases recover. I believe it is the
consensus of opinion among leprologists that leprosy is a self-limited
disease. Dr. Dyer especially entertains this view. Several cases have
recovered in Louisiana, and quite a number have recovered in Hawaii.
They have recovered in the sense that the active processes have all
ceased, and that the lepra bacilli are no longer to be found in the body.
When there is destruction of tissue, whether much or little, that, of
course, is never repaired, so that an advanced case of leprosy, even
though it does recover, may still be an unsightly mass of humanity.
Some have even held that the active life of leprosy is not more than
fifteen years; that the patients either die in that time, or that the
activity of the disease ceases. While this can not be accepted in toto,
it does indicate the general trend of the disease.
They have recently introduced in the leper settlement in Molokai
a system of paroling lepers from the station. Whenever all evidence
•eases and they can no longer find the lepra bacilli, the patient is set
at liberty with the understanding that he will report at the office every
three months, and as long as this condition prevails, he remains at
liberty. Sometimes they lapse back and are returned to the station,
but in other instances they remain well indefinitely.
The author has under observation at the present time a leper where-
in all evidence of activity of the disease has ceased, but the lepra
bacilli are still found in the nasal secretions. It should be observed in
passing that, while the outlook for recovery, once leprosy is established
(10?)
in the individual, is not good, still the suffering from the disease is
not great. In fact, a number of lepers, in San Lazaro Hospital assured
me that they had not been sick a day in ten years.
MANAGEMENT.
The management of leprosy varies greatly in different parts of the
world. Everyone is familiar with the instructions given by Moses for
lepers in the Hebrew camps. This, however, seems to have been more
a religious rite than a matter of sanitation. Late in the middle ages
and during the prevalence of leprosy in Europe, the isolation of lepers
was fairly rigidly enforced both by law and popular sentiment, and
above all by the edicts of the church.
The leper was to all intents and purposes dead. Dean Milman has
graphically described the church ceremony when a leper was sent into
sequestration. The rital differed little from the burial service. After
the leper had been sprinkled with holy water, the priest conducted him
into the church, the leper singing the song "Libera me Dominie," the
crucifix bearer going before. In the church a black cloth was stretched
over two trestles in front of the altar and the leper leaning at its side,
devoutly heard mass. The priest, taking up a little earth in his cloak,
threw it on one of the leper's feet, and put him out of the church.
* * * £ook him to his hut in the midst of the fields, and then uttered
the_ prohibitions : "I forbid you entering the church * * * or
entering the company of others. I forbid you quitting your home
without your leper's dress." He concluded: "Take this dress and
wear it in token of humility ; take these gloves, take this clapper, as a
sign that you are forbidden to speak to any one. You are not to be
indignant at being thus separated from others, and as to your little
wants, good people will provide for you, and God will not desert you.
When it shall come to pass that the leper shall pass out of this world
he shall be buried in his hut and not in the church yard"
It was these ceremonies that inspired that pathetic poem of Tenny-
son, "The Leper's Bride," in which a wife follows her husband into
exile, saying:
"You need not wave me from you,
I would leap into your grave."
How very complete this system of isolation was can best be ap-
preciated by remembering what a tenacious hold the church had upon
(UK)
its communicants in those days— how even kings didn't dare violate
the priestly mandates.
There is little room to doubt that it was this enforced isolation of
lepers effected chiefly by the church that gradually eradicated the
disease from countries where it once so extensively prevailed.
At the present time opinions differ widely as to what course should
be pursued with this disease. New York City, for example, pays no
attention to it. In 190G a leper by the name of George Rossett turned
up in Baltimore, Md. Rossett was a Syrian, and wanted to go to New
York. The health authorities of Maryland willingly gave him assist-
ance. He was put on a freight train and got as far as Philadelphia,
but New Jersey would not allow him to pass through, whereupon he
was shuttle-cocked back to Baltimore. Later he showed up in West
Virginia and died at Parkersburg. Commenting on the matter. Dr.
Doty, of New York, said: "What this leper wanted to do, probably.
was to get to New York where there is a large colon y of his people,
the Syrians, his hope being that his countrymen would help transport
him to his home. * * * Leprosy is one of those disorders medical
science knows little about. Dealing with facts as we do, and not with
theory, we have learned that though leprosy occurs in parts of the
United States, there are no reported instances of one case having
caused others. There is popular fear of it, but the facts as they have
been observed do not warrant the fear. * * * £> r Darlington and
I are agreed that in New York leprosy is not a factor in State sanita-
tion. We do not consider it at all further than to hold that in this
country it is not a menace to the public. There is no prohibition against
this poor outcast coming to New York."
Leprosy in New York used to be isolated on North Brothers Island, *
but in 1S9T they were set free and since that time they have been
ignored.
These views of Dr. Doty and Darlington represent one extreme.
Dr. Hunter, secretary of the State Board of Health of Colorado, rep-
resents the other. Dr. Hunter stated before the last conference of
State and Provisional Boards of Health of North America that he
would not even allow a leper to go through the State of Colorado.
In a general way the management of leprosy in Cuba is one of
isolation. Indigent persons when apprehended are sent to leper
hospitals, of which there are two in the island, and cared for at the
expense of the government. Persons with money are not required to
(100)
go to the hospitals, but are permitted to stay at home. However, the
leper must have his own room in the family, his own bed linen, eating
utensils, etc, and must not mingle with the rest of the household. The
sanitary inspector of the government calls occasionally, perhaps once
a month, to advise with the family and patient, and to see that these
instructions are carried out. It is not likely that they are strictly
adhered to in the inspector's absence.
In Hawaii the management of leprosy would seem to be all that
could be desired. On the island of Molokai is a mountain chain run-
ning parallel with the coast. Rivers make down from the mountains
in such a way as to completely enclose a considerable plain. This plain
is bounded on the one side by the ocean, on the opposite side by the
mountains, and at the two ends by rivers. Here is located the leper
colony of the Hawaiian Islands, It is here that Father Damien lived
and labored and contracted leprosy and died. The territorial govern-
ment of Hawaii is endeavoring to get rid of leprosy entirely by placing
all lepers in this colony. Those with means are permitted to leave the
country, but all others when apprehended are sent to Mulokai. They
are well cared for and given medical attention, and if accounts can be
trusted are reasonably contented.
They formerly married and were given in, marriage, but the govern-
ment disparages that now. When a child is born of leprous parents,
it is immediately taken away as before related and sent to Honolulu to
he brought up. Under this management the number of lepers has been
reduced in the last few years from nearly one thousand to some five or
six hundred. But there are still a number of cases of leprosy occurring
in the island.
In the Philippines a similar management under Victor Heiser
has been instituted. AH lepers as they are apprehended are transferred
to one of the islands set aside for that purpose. This will undoubtedly
lessen the number of lepers. But owing to the fact that leprosy can
not be diagnosed early there will always be a residue of lepers among
the remaining population. From these considerations it is certain that
leprosy may be entirely ignored on the one hand as it is in New York,
and not be followed by any immediate disaster, and that it can be
isolated with the greatest precision possible on the other hand as it is
in Hawaii, and not be followed bv immediate eradication. That almost
(110)
amounts to saving that it matters little what we do or don't do, we will
affect very slightly the immediate increase or decrease of leprosy.
We must not forget, however, that leprosy once prevailed all over
Europe; that law and sentiment and religion combined to enforce
isolation of the afflicted and that finally the disease has practically dis-
appeared. Nor must we forget that leprosy was in Asia even before
it was in Europe; that the isolation it gets over there hardly deserves
the name, and that instead of disappearing as it has in Europe, it is as
prevalent there today as it has ever been. All of which would indicate
that although it may take centuries to bring it about, a reasonable isola-
tion of those afflicted with leprosy is our only hope of ultimately rid-
ding the world of its oldest and most dreaded disease.
STATISTICS.
SMALLPOX,
During May, 1913, smallpox was reported from the following
counties [1,630 points of vaccine were distributed):
Aladiua 1
Brevard I
Dade 2
Duval .- 37
Escambia , 20
Levy 2
Manatee 10
Marion 1
Pinellas 1
Polk- 1
Putnam 5
Santa Rosa . 1
St. Johns 11
St. Lucie 1
Total. May 04
Total reported cases, 1913 8S1
RABIES.
During May, 1013, anti-rabic treatment was administered in the
following counties :
(Ill)
Alachua , s
Duval - 1
Hillsboro • 1*
Lafayette !
Leon , 1
Total, May 8
Total persons treated, 1913 W
Total deaths from hydrophobia, 1913 2
♦Treatment ineffective on account location of bite. Patient
died in 30 days.
GLANDERS.
During May, 1913, glanders was found in the State as follows :
Duval Cotfnty 8 cases
Total cases glanders in Florida, 1913 16 cases
koc cholera (Distribution of Serum).
Amount hog cholera serum distributed, May 39,500 c. c.
Amount hog cholera serum reported administered by agents. May 9,780 c. c
Number hogs reported treated in May .462
Total weight hogs treated, pounds 26,050 c c
Number agents appointed, May. 4
Total number agents appointed to June 1 160
TICK ERADICATION.
During May the following counties were visited by Tick Eradica-
tion Agents of the State Board of Health: Bradford, Alachua,
Marion, Osceola, Hillsboro, Pasco, Pinellas.
Clubs were organized during May in the following counties: Pasco,
Hillsboro.
In May cattle dipping vats were built in the following counties :
Osceola 1
Alachua 2
Pasco 1
Marion 1
Total number vats constructed. May 5
Total number vats constructed to June 1 14
During the month of May public demonstrations of dipping cattle
were held at Wacahoota (Alachua Co.), Mcintosh (Marion Co.),
Citra (Marion Co.), Tampa (Hillsboro Co.), Kissimmee (Osceola
Co.).
PUBLICATIONS.
During May one publication was issued by the State Board of
Health, viz. :
(112)
Publication No. 106, Mosquitoes.
Total literature distributed in April (not including Health
Notes, or mailing list of Annual Reports), 1,075 pieces.
SPECIMEN EXAMINATION, BACTERIOLOGICAL LABORATORIES.
Jacksonville Tampa Pcusacola
Animal Parasites 187 112 58
Diphtheria 218 77 16
Gonorrhea 34 26 37
Malaria }.... 213 228 17
Pathological 6 7 1
Rabid Dogs 9 1
Tuberculosis 146 77 42
Typhoid Fever 157 116 10
Water (for sewage contamination) 11
Miscellaneous 147 13 29
Totals 1.12S 656 208
Grand total number of specimens examined by the State Board of Health
Laboratories, May, J913, 1,992.
BOOK REVIEWS.
Those who are interested in public health matters and clean politics
will enjoy reading: "The Career of Dr. Weaver," by Mrs. Henry
Backus.
The story is charmingly written and holds the reader's interest to
the final page. The Notes especially commends the book to its medical
friends. The morals taught are high, and the author brings out the
character of a physician who forcibly condemns a practice which offers
many temptations to the specialist, to whom "money getting" has in
these latter days, seemingly, in many instances, overshadowed the high
ideals of the Hippocratic oath.
The type is sufficiently large and clear so that reading will not be
tiresome or a strain to the eves either on train or boat.
At a meeting held at Jacksonville, June 10, for the purpose of re-
organizing the State Board of Health, the following officers were
elected : Hon. Frank J. Fearnside, of Palatka, President ; Joseph Y.
Porter, M. D., of Key West, Secretary and State Health Officer. Hon,
Frank J. Fearnside, of Palatka. Hon. C. G. Memminger, of Lakeland,
and Hon. S. R. Mallory Kennedy, M. D., of Pensacola, comprising
the new Board, were appointed by Governor Trammell to assume
office June 1, 1913.
J
t vORio 4
Health HHBNotes
OFFICIAL BULLETIN
Published Monthly by the
STATE BOARD OF HEAiLTH
Subscription 59 cents per Annum
Entered as Second Class Matter, April 20, 1910,
At the Postoffice at St. Augustine, Florida, Under the Act of July 18, 1894.
Vol. VIII July, 1913 No. 7 (JX)
Hon. Frank J. Fearnside. President, Hon. S. R. Maixoby Kennedy, M. D-,
Palatka, Fla. Pensacola, Fla.
Hon. C. G. Memminc-ER,
Lakeland, Fla.
EDITED BY
Joseph Y. Porter, M. D., Secretary and State Health Officer.
Hiram Byrd, M. D., Assistant State Health Officer.
EXECUTIVE OFFICE AND CENTRAL LABORATORY:
State Board of Health Building,
Springfield Boulevard,
Jacksonville.
BRANCH LABORATORIES :
State Board of Health Building
Florida Avenue and Constant Street, Tampa.
City Hali, Pensacola.
Sent to any address in the State for the asking.
If you receive it without asking, it means that someone else has requested
it for you.
When you change your address drop us a card.
When giving change of address, give both the old and the new.
Anything you want to know about the public health we will try to tell you.
Any information you want about communicable diseases of domestic animals
we will help you to get.
Address communications to Jacksonville, Fla,
Men who are occupied in the restoration of health to other men by the joint
exertion of skill and humanity are above all the great of the earth. They even
partake of divinity, since to presen'e atid renew is aim as t as great as to create.
— Voltaire.
(114)
RABIES IN FLORIDA.
By Henry Hanson, A.M., M.D.,
Senior Bacteriologist, State Board of Health of Florida.
[Read before the State Medical Association, Miami, Fla., May 15, 1913.]
One is almost compelled to say that rabies exists in Florida because
the Floridians want it ! This is sad but true. There are certain things
which the people can have if the people want them. Rabies is one of
these. If one consults the statistics on the subject, it will be found that
the accumulated facts support these extraordinary statements. There
are few public health measures which have met as persistent opposition
as have the efforts aiming at rabies eradication. There is no disease
which causes greater agony than hydrophobia. It is also true that
there is no disease which is more easily preventable than hydrophobia ;
when the people of the community will allow the health authorities to
prevent it. Only two simple measures are necessary — a license tax
which is enforced and a muzzling ordinance.
Here I wish to quote from the twenty-fourth Annual Report of the
State Board of Health, 1912, letter of transmittal by the President of
the Board- The paragraph referred to is found on page 10 and refers
to smallpox, I am substituting the word hydrophobia for smallpox,
which makes the paragraph read as follows :
"We have had, during the year, hydrophobia as usual. This is a
very instructive disease. It teaches that, although a disease may be
entirely preventable, still we refuse to prevent it; not through failure
or neglect on the part of the health authorities, but through opposition
to accepting the only known method of prevention."
What the State Health Officer says on page 34 of the same report
can also be applied to hydrophobia. If one compares the results as set
forth by statistics from England and Australia, where rabies is at
present unknown, it will be seen that England eradicated rabies by
enforcing an effective muzzling ordinance. Australia has never had
the disease, due to the fact that she does not allow a promiscuity of
existence among the canine species. Quarantine laws and muzzling
ordinances in Australia are such that the disease could not be imported.
Compare these results with those of this country (and this State is no
exception) "where a 'do as you please* policy seems to prevail and
where especially ignorance is permitted to dwarf reason and demigog-
ism receives plaudits," and one can see why hydrophobia continues to
flourish. The last three lines can well be applied to the conditions which
j
(115)
have existed in the city of Jacksonville for the past twenty-six months
so far as efforts to control the dog situation are concerned. This
matter has not been in the hands of the right department of the city
government and all efforts to impound stray and homeless curs have
been made spasmodically and ineffectively. This inefficiency has been
the cause of a great deal of unjust criticism of the City Health Officer
who has kept up a desperate but losing fight to have the muzzling
ordinance enforced and homeless curs impounded. The attitude taken
by an afternoon daily and a weekly publication in the city has done a
great deal to defeat the efforts of the State and City Health Depart-
ments to make Jacksonville a place where it might be safe to let little
children play out in their home yards or in the parks, two places where
they have undisputed right to play, without being mangled by worthless
rabid curs. There are those who will say that I am "knocking Jackson-
ville," but such is not the case. I am simply pointing out some very
serious obstacles in the path of the city's wonderful forward march.
I am a property owner in the city and am, therefore, the more interested
in her prosperity, and certainly can have no reason to engage in a
"knocking" venture.
I will cite two instances which will lend weight to the fact that the
city has not been a very safe place for children to play in or even live in.
One of these occurred in my own home. A rabid dog ran into my
dining room where I cornered him by means of a large sofa cushion,
grabbed him by the back of the neck, carried him out and shot him
through the heart while I still held him. The head of this dog was
examined at the laboratory and showed negri bodies.
The second, a more recent occurrence, where a rabid dog entered a
house in West Jacksonville and bit two children in their own home. No
one can appreciate the mental torture of the parents except those who
have experienced such trials.
During the past twenty-six months the number of children who
have been bitten, within the city limits of Jacksonville, is too great to
mention individually ; an enumeration by the localities and ages of the
little victims ought to be sufficient to arouse every fair-minded indi-
vidual to earnest co-operation for the complete suppression of the dis-
grace to the State which this rabies situation is.
During 1911 thirty-three children, between the ages of two to ten
years, were bitten by rabid animals in Duval county, most of whom
were in the city of Jacksonville. Seven of these were two-year-old
babies. Four three years old and fourteen were four to five years old.
(116)
Sixteen other children, between the ages of two and ten years,
were bitten in various parts of the State. In this same year forty-two
persons older than this were bitten in Jacksonville. The total number
of persons for whom the State Board of Health provided treatment
was 115.
During 1912 the total number of persons for whom the State Board
of Health provided treatment was 114; evidently the lesson of the
previous year was not sufficient. Of this number forty-eight occurred
in Jacksonville and Duval county, and thirteen of these were children
of the ages two to ten years, one two years old, two three, two four,
three five and five seven to ten years old.
In Hillsboro county twelve children of the ages two to ten years
were bitten ; of these one was two years old and two three years old.
During 1912 thirty-seven children of these tender and helpless years
were bitten, and yet the people of the State do not seem to care, as is
clearly manifested by the way the year of 1913 is, starting out. During
the first four months of this year twenty-four children, less than ten
years old, have been bitten and provided Pasteur treatment by the
State Board of Health. A total of fifty-three treatments has been
ordered by the Board during the first four months of the present year.
It is not enough that in the past twenty-six months these 281 persons
have been obliged to submit to the disagreeable and painful Pasteur
treatment, but we know from our statistics that more than one per
cent of those treated must die. Without treatment sixteen per cent die.
We save fifteen out of every hundred bitten; the other eighty-four
possess sufficient immunity to destroy the virus.* Paltauf found in
doing post-mortems on four individuals who died from some inter-
current disease shortly after being bitten by rabid animals that the
medulla of these men emulsified and injected subdu rally infected rabbits
with rabies; showing the presence of active virus in the patients'
nervous tissue, but this virus was in an attenuated condition since the
inoculation period in the inoculated rabbits was unusually long. This
does not hiean that each of these would have developed the disease but
rather that the virus reached the central nervous system and was there
destroyed by the defensive mechanism in the brain without producing
symptoms. These agencies are made more effective by the immunizing
process of the Pasteur treatment. In other words, rabies-inoculated
men usually develop a latent infection which is overcome without the
*Herzog, Disease Producing Microorganisms.
(117)
symptoms of rabies. Such is the case in the eighty-four per cent that
do not develop hydrophobia although the Pasteur treatment is not
administered.
In three other persons, who were bitten by a rabid animal and died
from other diseases shortly after completion of the Pasteur treatment,
the medulla was found non-infectious to rabbits, indicating that the
virus was destroyed by the process of the Pasteur treatment. The
virulence of the virus is the deciding- factor whether or not the disease
will be overcome. The deaths occur in cases where the virus reaches
the brain before the effect of the Pasteur treatment has become effec-
tive.
There is a financial side to this question which ought to interest
those who are not interested in the humanitarian side. The State Board
of Health began furnishing treatments in 1908 and during the first five
years $8,325 was paid out by the Board for treatments. The first four
months of this year has swelled that sum to $9,075, every cent of which
has gone out of the State without a fraction of a dollar's return. Other
expenses in connection with these treatments, due to fees for administra-
tion, loss of time, etc., has doubled this expenditure so that one can say
that 384 dog bites have cost the State over $18,000, and most of these
are made by the ownerless and homeless cur. This ought to put a
valuation of nearly $50.00 on each dog. Since I have examined most
of these animals I know that more than three hundred were such that
no one would pay fifty cents apiece for them.
The loss to Duval county during the past twenty-six months in
horses, mules, cattle and valuable high-bred dogs and other domestic
animals amounts to over $15,000. I have not been able to secure
sufficient data to be able to estimate the property loss to the State in
general, but know that a large number of such animals have died from
the effects of hydrophobia.
In my last annual report I stated that there is some presumptive
evidence that the disease is getting a foothold among the wild animals
of this State, which is a very serious matter, indeed.
In the past five years the disease has existed in thirty-four counties
and sixty-six separate localities. Each year we find the disease in
localities where it has not heretofore been known. In 1908 rabies was
reported from six localities in the State. In 1909 from seventeen
localities, fourteen of which had not previously reported rabies. In
1910 from twenty-one localities, fifteen of which had not previously
reported rabies. In 1911 from twenty-two localities, eleven of which
(118)
had not previously reported rabies. In 1912 from twenty-seven locali-
ties, nineteen of which had not previously reported rabies. The total
of which shows sixty-six points distributed through thirty-four coun-
ties.
Since the beginning of 1908, 550 animals have been examined in the
laboratories of the State Board of Health, 385 of which have definitely
proven to have had hydrophobia and in that time have bitten about four
hundred human beings and a much larger number of domestic animals
of all kinds.
It would seem that what I have already said ought to be sufficient to
cause the people of the State to take a very decided action in regard to
the rabies situation. It is, nevertheless, a curious fact that certain
persons and newspapers in the State become very loud in their denunica-
tion of all statements of facts of this nature. They are always harping
on the injury which these plain facts are to the State. If these individ-
uals would direct the same amount of energy towards supporting the
measures for eradication of this evil rather than trying to suppress the
facts and allowing it to exist unchecked, they might be able to sway a
certain portion of public sentiment to the point where the situation
would be controlled as it should be.
Recently a weekly paper of Jacksonville has criticized Dr. Porter
for publishing a statement to the effect that there are approximately
twenty thousand tubercular patients in the State of Florida. This state-
ment seems to have stirred up the anxiety of the editor about the injury
which this information is going to do the State, Dr. Porter's state-
ments are true, but they are not worse than statements which could be
made about any other State in the Union. The proportion of tuber-
culosis in the United States is very nearly the same in all States, but
the fact remains that some States are doing a great deal more for their
patients than others. Florida is delinquent in her care of the tuber-
culous.
When bubonic plague broke out in San Francisco there was a
tremendous amount of pressure brought to bear upon the health author-
ities to suppress the information in regard to the existence of plague in
San Francisco. The consequence of which was that the disease con-
tinued to spread. It was only after the situation was aired and the
people of San Francisco were made to understand very clearly that
plague existed there and was at that time on the increase that the
public health authorities received sufficient co-operation to institute the
measures necessary for its eradication among humans. The efforts at
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suppressing the information led to the establishment of plague among
rodents and squirrels on the Pacific Coast.
This hue and cry by those who are afraid that the information we
are giving out in regard to disease conditions is going to injure the
State has resulted in obstructing the public health measures to the point
where all efforts at eradicating the said disease has been ineffective and
has allowed hydrophobia to spread throughout thirty- four counties in
this State.
Florida, on account of her location, can eliminate rabies from the
State with very much less effort than any other State in the Union ; no
rabid animal can enter the State from the east, south or west with the
exception of a very narrow strip at the west end of the State. A proper
enforcement of a dog ordinance directed against homeless curs and the
worthless mongrels would make conditions such as we have had in the
past twenty-six months impossible.
The reasons which I have given for stopping this evil ought to be
sufficient, but as it seems that they are not I will mention a few
tragedies.
Seventeen deaths of humans have occurred in this State since 1903.
Six of these took place prior to 1911.
The first of which I have record is the case of a negro in Talla-
hassee, who is said to have been bitten on the arm by a cat.
The second a negro child in Pensacola early in the winter of 1903 ;
Dr. Pierpont and Dr. Hiram Byrd saw this case.
The third a grandson of Col. Bob. Davis, whom Dr. Wm. Stinson
attended. This occurred in Jacksonville.
Fourth. The case of the Dees child, which Dr. Stinson also has
information of.
Fifth. A person named Sweat in Ocala, which occurred in 1908.
Sixth. Case of a man at Carrabelle in the practice of Dr. B. B.
Blount. History of this case is on file in the office of the State Board of
Health.
Seventh. Case of an old man at Otter Creek, a patient of Dr. J. W.
Turner.
Eighth. Alfred Miller, a boy eight years old, on Myrtle avenue,
Jacksonville ; patient of Dr. R. L. May. This case was reported to the
State Medical Society at Tallahassee in 1911, and also in the Journal
American Medical Association, December 23, 1911, volume 57.
Ninth. Clarance Lowther, large robust man, bitten above the eye.
(120)
who died on the twenty-first day after being bitten; a patient of Dr.
Frederick Bowen, Jacksonville.
Tenth. A colored child in Riverside; case reported by the City
Health Department, Jacksonville.
Eleventh. Colored child on Evergreen avenue, Jacksonville ; patient
of Dr. Randolph, summer of 1912.
Twelfth. Patient of Dr. Smoak in Tampa, summer of 1912.
Thirteenth. A case at Starke, Fla. ; patient of Dr. A. H. Freeman.
Fourteenth. Case at Tampa ; patient of Dr. Bartlett.
Fifteenth. Case near St. Augustine; patient of Dr. DeWitt Webb.
Sixteenth. Rudolph Dasher, a child on Florida avenue. This child
was given Pasteur treatment by Dr. B. Smith ; at the time he developed
rabies he was a patient of Dr. Geo. Mitchell, of Jacksonville. Died in
March, 1913. This was a case where the biting was unusually revolt-
ing. The child was playing on the walk in front of the house and was
attacked by a cur dog, which threw the child to the pavement and bit
him in the nose and mouth in such a way that it had two puncture
wounds in the palate. He also bit the child on the arm and hand. This
case is rather unusual in that the Pasteur treatment, which was secured
very promptly, was finished and the symptoms did not develop until
five months later. Our explanation for this can only be that the treat-
ment delayed the disease but did not produce immunity sufficient to
ward it off. We did not expect at the time the child was bitten that it
would survive and expected fully that the symptoms would develop
before the completion of treatment.
The seventeenth case I only have indefinite information of. It is
reported by Dr. Bartlett to have been a case outside of the city of
Tampa.
What excuse can our State authorities offer for the death of these
seventeen human beings ? Are the dogs of this State worth more than
these seventeen humans? They forget that good dogs can exist with-
out any opposition on the part of the health authorities or any one else,
and such dogs be free from hydrophobia if they will only support us in
controlling the stray cur and allowing us to suppress the disease when
it comes to our notice.
"What has your boy learned at school so far this term?"
"He has learned that he'll have to be vaccinated, that his eyes aren't
really mates and that his method of breathing is entirely obsolete." —
The Pathfinder.
(121)
TICK ERADICATION BILL AS PASSED BY
THE LEGISLATURE.
An Act to provide the State Board of Health with funds for the
eradication of the Southern cattle tick, Morgaropus annulatus; to
authorize the county commissioners of the various counties to appro-
priate funds to be used in such work ; and to permit the appointment of
federal officials as agents without pay.
Be it enacted by the Legislature of the State of Florida:
Section 1. The State Board of Health is hereby authorized, em-
powered and directed to expend, under the regulation provided by
existing law, such amounts as the Board may deem necessary and ex-
pedient, out of the funds derived from the operation of Chapter 4693,
Acts of 1899, in the control and eradication of the Southern cattle tick,
Morgaropus annulatus; through the employment of State and county
agents, payment for labor and materials, and for any other expendi-
tures that may be found useful and necessary in the prosecution of such
work; and the State Board of Health is hereby authorized and em-
powered, after investigation of suitable locations, and upon recom-
mendation of the Executive Committee of the Florida State Live Stock
Association, to construct cattle dipping vats in communities where
such aid is deemed useful for demonstration and proper conduct of
tick eradication work.
Section 2. The county commissioners of any county of the State
are hereby authorized and empowered to appropriate such amounts as
they may deem adequate and necessary, for the purpose of co-operating
with the officials of the State Board of Health in eradicating the
Southern cattle tick, Morgaropus annulatus, and preventing contagious
and infectious diseases of live stock, or whenever funds for this purpose
are raised by private subscription of individuals.
Section 3. The State Health Officer is hereby authorized and
empowered to appoint such officials as may be detailed by the United
States Department of Agriculture for co-operative work in the eradica-
tion of the Southern cattle tick, Morgaropus annulatiis J or the control
or suppression of any contagious or infectious disease of live stock, in
Florida, as Agents of the State Board of Health; provided they act
without pay from the State of Florida.
Section 4. This Act shall go into effect upon its passage and
approval by the Governor, or upon its becoming a law without his
approval.
(123)
Sanfokd, Fla., June 14, 1913.
Dr. J. Y. Porter,
State Health Officer,
Jacksonville, Fla.
Dear Sir : A bill was introduced in the Legislature by Representa-
tive Lake, of Orange, to prevent the use of artesian wells as receptacles
for sewage. This bill was so changed in the Senate as to allow the
overflow of "septic tanks" to pass into the wells.
The direct use of the wells is the system in Ocala. Orlando is on
the point of installing septic tanks, but during the past five years the
wells have been used directly for the discharge of sewage from a
number of large buildings, such as the San Juan hotel, the Arcade, the
Abernathy building, and the Watkins block.
Is there not, in this use of the wells by the higher sections of the
State, great danger to all towns using artesian water for drinking
purposes ? Can it be guaranteed that the treatment in the tanks renders
the sewage thoroughly innocuous, and that there will be no danger in
this method of sewage, when it shall be adopted by an increasing num-
ber of growing towns and continued through many years ?
We owe it to those who shall come after us, to preserve in unim-
paired purity the supply of artesian water which is justly counted as
one of Florida's greatest blessings. The State Geologist, in his report,
condemns the use of the wells for sewerage, and says that it is a danger-
ous practice and should not be permitted. This, of course, refers to the
direct use ; but unless the permanent and absolute efficiency of the tanks
as germ destroyers can be assured, there must be serious danger in
turning their overflow into the wells, and it is not only possible, but
highly probable, that in the actual operation as time goes on, there will
be failures to keep the tanks up to the point of efficiency which may
be claimed for them, so that the water supply will become contaminated,
and this would be a serious matter to the whole State, not only from a
sanitary point of view, but from a commercial one as well. And the
evil may then be irremediable.
A committee has been appointed by the Woman's Club of Sanford
to investigate this matter, and we are writing to you for information
especially regarding the system as proposed at Orlando, our own supply
being in the opinion of experts identical with the underground stream
into which Orlando's sewage will be discharged.
Winter Park has just completed an elaborate water system, using
artesian wells. If this overflow from Orlando's tanks passes into this
artesian water, Winter Park will probably substitute lake water for
artesian, and abandoning the wells as a source of drinking water, use
them for sewage as in Orlando. Then Maitland, Altamonte and Long-
wood will follow suit. But Sanford and Kissimmee, north and south
of Orlando, lie at a lower elevation, and the water rises to the surface ;
(123)
consequently these towns could not use the wells for sewage if they
wished ; but surely the water would be unfit to drink.
We realize that in time, with air and sunlight, flowing water purifies
itself, but is it the same with underground streams, and within this
comparatively short distance?
Jacksonville, St. Augustine and most of the East Coast towns, many
on the Gulf and in the interior, depend upon this artesian supply of
drinking water, and in view of its widespread importance, it seems
almost imperative that this question should have an authoritative
answer, affirmative or negative: "Is there, in this system of sewerage,
a menace to the public health, now or in future?"
We beg that you will take this very serious matter into considera-
tion and favor us with a prompt reply. Yours respectfully,
Health Committee,
Woman's Club of Sanford.
Jacksonville, Fla., June 18, 1913.
Chairman Health Committee, IVoman's Club of Sanford,
Sanford, Fla.
My Dear Madam : I have your letter of June 14th, and allow me
to say first of all that it is exceedingly refreshing to get a letter of this
kind, one in which an intelligent inquiry is made rather than a "knock"
in the guise of an inquiry. I take great pleasure in going over the
question of sewage disposal and the pollution of underground waters
in this State with you.
As you have pointed out, Orlando, Ocala, and you might have added
Live Oak, Madison and possibly some other places, have been, for a
number of years, emptying raw sewage into the ground. This the
State Board of Health has always disparaged — raw sewage, you under-
stand.
Sewage may be treated in such a way as to become innocuous. For
example, several years ago Tallahassee instituted a system of septic
tanks, the first in mis State. All the sewage of the town is run through
those tanks. When the effluent passes out of the tanks, it is clear,
sparkling water. I have repeatedly had it examined bacteriological ly
and chemically, and it comes up to the bacteriological and chemical test
of drinking water. Consequently that water can be emptied into the
ground, into a creek or anywhere with absolute assurance that it will do
no harm.
The septic tank idea is rather a new one, and is more or less difficult
to understand, but after all, the principle is not so complicated. For
example, a very simple test may be carried out as follows: A glass
bottle or demijohn may be filled with raw sewage, and set aside and
allowed to stand for a few weeks. In the course of time there will be
nothing in the bottle but a little sediment at the bottom, and the clear,
sparkling water above. "What has taken place ?'* is the question ; the
water above is next to sterile, and could be emptied anywhere with
(124)
absolute safety. The sediment in the bottom is sludge, mineral matters,
which go to make soil. The thing that has actually taken place is this:
The bacteria contained in the sewage have reduced it to its simplest
elements, water on the one hand and mineral matters on the other, and
the bacteria in turn have died of starvation, there being nothing
left in the sewage for them to feed upon. It is a process of self-
purification. This is exactly what takes place in the septic tank on a
large scale. This is what has taken place in the septic tank at Talla-
hassee, from which the effluent is a relatively pure water.
Now, with the septic tank properly constructed, this effluent can be
made as pure as desired. It can be made to have a higher degree of
purity than the lakes from which Sanford and Orlando take their drink-
ing water.
The plan that has been proposed for Orlando has been carefully
gone over in this office. It has been approved by a consulting engineer
in New York, whose opinion is worthy of the highest consideration.
This office sees no reason why it should not be carried out as proposed,
but on the other hand, regards it as the best solution of the sewage
problem yet proposed for that city.
There is one fear mentioned in your letter which is legitimate, and
that is whether or not the plant might fail to work and in that way the
underground waters become contaminated, and once contaminated, the
impossibility of correcting it. There are two answers to that : First,
it is hardly likely that the plant will fail to work, and if it does, it would
only be in a very minor degree, "so that the contamination of under-
ground waters would be, at most, in all probability, a great deal less
than from a single one of the wells now in Orlando; ana, furthermore,
such contamination is very short-lived and very limited in its territory.
Typhoid bacilli, for example — and that is what we are most to be con-
cerned about — will not live but a few days in water. It is reasonably
safe to say that any contamination of that kind would completely dis-
appear within, say, two weeks. The other part of the answer is, that
it would not be widespread. The State Geologist of Georgia, in con-
junction with the municipality of Quitman, a few years ago had a ques-
tion of this same kind to answer. It was proposed at that time to run
the sewage of the town of Quitman into the ground. The inquiry was
made wheUier or not it would result in contaminating the adjacent
waters, for there were a number of deep wells not far from the
proposed point at which tiie sewage was to be emptied. A gigantic
experiment was undertaken to test the matter out in this way. The
salinity of all the adjacent wells was accurately measured, and then a
saturated solution of sodium chloride was poured into the sewer well
in a continuous stream, as I remember, for several days (five I think),
and the salinity of the adjacent wells accurately measured each day.
All wells three-quarters of a mile away and further were absolutely
unaffected. Within that range the salinity was increased.
In view of the persistence of salt in water and of the evanescence
(125)
of typhoid contamination, it is generally conceded that this test is liberal
and that the results may be relied upon.
I am exceedingly glad that you have taken the matter up, and I
assure you that the public health will not be jeopardized, or under-
ground water polluted, whenever the State Board of Health can prevent
it.
I may add, in this connection, that it is the Imhoff tank which it is
purposed to install in Orlando, and that that is the latest word in the
construction of septic tanks.
If we can be of further service to you, it will be a pleasure.
Yours very truly,
Joseph Y. Porter,
State Health Officer.
This office is in receipt of a letter asking for full information regard-
ing the home treatment of tuberculosis.
The Notes is sorry to have to advise that home treatment at best is
unsatisfactory. It must not be inferred from this that people do not
recover at home, for they do. In fact it should be distinctly understood,
first, last and all the time> that most people get tuberculosis infection
during life. There is a German saying that every man has tuberculosis
before he dies. This is almost literally true. Many people have it and
get well without ever suspecting they have it. Of those that find out
they have it,
Some get well regardless of treatment,
Some die regardless of treatment,
but between these two classes of cases is a group which with the best
of care recover, without it they do not. It is in this group that treat-
ment is of most importance. If one could forecast in the beginning
whether a given individual falls in group one, two or three, it would
be relatively easy to deal with them. Group one could be treated at
home. Group two should be made as comfortable as possible during
their declining days. Group three should be sent to the best sanitarium
to be had and just as soon as possible, and kept there as long as neces-
sary to effect a complete recovery.
But not being able to tell which group a given case belongs in, it is
necessary to either take chances on life or send it to a sanitarium. If
the best possible is done for a case and it doesn't eventuate well, there
should be no self-chiding. But if anything short of the best possible
is done, then there is room for regrets.
(126)
The best possible may be to stay at home, for sanitarium treatment
comes high. It may be that the means are not to be had for it. If that
is the case, don't, three times DON'T, send one away from home. It is
a fatal mistake to send a patient "West" without means. He is almost
certain to go backward. There are then two proper courses to pursue
when one discovers tuberculosis in the family. If you have the means
send him to a good sanitarium ; if you don't, keep him at home.
If you keep him at home, place him under competent medical super-
vision.
Interdict all work of every kind.
Breathe fresh air twenty-four hours each day.
Whenever there is any fever keep patient in bed.
K fever rises 'in the afternoon, allow very little stirring about in the
morning.
At all times keep patient as comfortable as possible.
If constipated, take a little simple laxative, as epsom salts.
Eat regularly and bountifully of simple but well prepared foods.
Milk and eggs are the sheet anchor.
All this in the interests of the patient.
There are others in the house. They must be protected. This is
particularly true for little children. The tendency now is to believe
that most cases of tuberculosis are contracted during childhood. There-
fore protect the child.
The patient should sleep alone. Should have his own bed linen,
table linen, etc. A large napkin should be spread under his plate so as
to protect the table linen. This should be removed with care after each
meal. He should have his own eating and drinking utensils and above
all he should be careful about spitting. A sputum cup of paper should
be used, and this burned. The patient should use paper handkerchiefs,
and these burned. The napkin used at the table as well as the, one
spread under the plate should be of paper, and burned. The patient's
hands and face should be washed frequently.
These are only some of the things to do. But the one thing to
remember is that a particle of saliva from a patient's mouth no larger
than a mustard seed may contain many, many tubercle germs, and
these should be protected against at all times.
This do to the best of your ability, and trust to luck that the patient
is in group one.
(127)
INGERSOLL'S REPLY.
A young man who sought a clerkship in one of the departments
at Washington once asked the late Robert G. Ingersoll for his en-
dorsement and this was IngersoH's reply:
"Young man, I would rather have forty acres of land, with a log
cabin on it and the woman I love in the cabin — with a little grassy,
winding path leading down to the spring where the water gurgles from
the lips of the earth, whistling day and night to the white pebbles a
perpetual poem — with hollyhocks growing at the corner of the house,
and morning glories blooming over the low-thatched door — with lat-
tice work over the windows so that the sunlight would fall checkered
on the dimpled baby in the cradle — and birds, like songs with wings
hovering in the summer air — than be clerk of any government on
earth."
In London the suffragettes pulled off a few stunts of window
smashing, for which they were promptly lodged in jail. In fact they
court getting in jail. They even boast that they will get in jail for what
they are doing, but that is a small matter.
After getting in jail they don't seem to be sufficiently in the spot
light. They refuse to eat. They are not satisfied with being ordinary
criminals — they desire to be treated as political prisoners, instead of
common street offenders. The officials have refused. They therefore
refused to eat, whereupon, the prison physicians force-feed them. And
that has caused a scrap in political circles, the point at issue being
whether a physician, who has charge of a prison, should force-feed a
prisoner, because she refuses to eat on the ground that she should be
treated as a political prisoner, and that the government treats her as
a common convict.
The reasons why communicable disease as scarlet fever can not be
controlled is that the mild cases are not diagnosticated till the disease
becomes well established.
For example, in Reading, Ohio, the disease has recently been
studied and it was found that in August only 20 per cent of the cases
were reported; September, 33 per cent of the cases were reported;
October, 66 per cent were reported ; November, December, January and
February, 100 per cent of the cases of scarlet fever were reported.
Then the disease stopped. In other words, as soon as it was known
that there was an epidemic of scarlet fever present, everybody looked
for it, and everybody found it.
(128)
PROPER AMMUNITION.
Finley Peter Dunne, creator of "Mr. Dooley," was dining with a
friend at a New York restaurant. Rice-birds were served. The tiny-
morsels, picked and lean, were brought in on large slices of toast.
"Poor little things!" said the host. "Seems a shame to kill 'em,
don't it? How do you suppose they ever murder enough rice-birds to
make a dish?"
Dunne turned over an infinitesimal specimen with his fork. "I don't
know," he said, "unless they use insect-powder !"■ — Pathfinder,
CONTAGION.
Little George had heard a great deal said about disease germs, such
as tuberculosis, etc. One day the family were at dinner, and George
wanted a drink of water. The tired mother said:
"Drink out of your uncle's glass, George : he is through eating,"
The little fellow commenced to cry, and said :
"I don't want to ; I'm afraid I will catch the backache."- — Bnstis
Lake Region.
A bird dog belonging to a man in Mulvane disappeared. The
owner put this ad. in the paper and insisted that it be printed exactly
as he wrote it:
"Lost or run away — one liwer culered burd dog, called Jim. Will
show signs of hyderfobby in about three days."
The dog came home the following day.
Mamma — Now, Freddy, remember what I say. I don't want you
to go into the next yard to play with that Binks boy ; he is very rude.
Freddy (heard a few minutes afterwards calling over the fence) —
Hello Binks, ma says I mustn't play in your yard because you're rude,
but you come into my yard — I ain't rude,- — Pathfinder.
A Frenchman named Yves de Lage, has just issued under the
auspices of the French Academy of Sciences, a "monkey dictionary."
It contains the speech, chatter and songs of monkeys. It is not intended
for the sure-enough monkeys to use— just for those that are studying
monkey language. There is a difference.
If you want to be safe against smallpox, don't wait for it to come
round — get vaccinated and have it over.
t vORio 4
Health tBWNotes
OFFICIAL BULLETIN
Published Monthly by the
STATE BOARD OF HEAiLTH
Subscription 50 cents per Annum
Entered as Second Class Matter, April 20, 1B10,
At the Postoffice at St. Augustine, Florida, Under the Act or July 16, IBM.
Vol. VIII August, 1913 No, 8 (JX)
Hon, Frank J. Fearnside, President, Hon. S. R. Mallory Kennedy, M, D.,
Falatka, Fla. , Pensacola, Fla.
Hon. C. G. Mem mincer,
Lakeland, Fla.
EDITED BY
Joseph Y. Porter, M. D„ Secretary and State Health Officer.
EXECUTIVE OFFICE AND CENTRAL LABORATORY :
State Board of Health Building,
Springfield Boulevard,
Jacksonville.
BRANCH LABORATORIES !
State Board of Health Building
Florida Avenue and Constant Street, Tampa.
City Hall, Pensacola.
Sent to any address in the State for the asking.
If you receive it without asking, it means that someone else has requested
it for you.
When you change your address drop us a card.
When giving change of address, give both the old and the new.
Anything you want to know about the public health we will try to tell you.
Any information you want about communicable diseases of domestic animal*
we will help you to get.
Address communications to Jacksonville, Fla.
That dire disease, whose ruthless power
Withers the beauty's transient flower,
— Goldsmith.
(130)
VITAL STATISTICS.
In his annual report of 1912 to the State Board of Health, the
State Health Officer discusses the question of vital statistics for Flor-
ida, and the following extract is taken from his report :
It is to be regretted that Florida is not in the registration area of
vital statistics which the United States Census Bureau prescribes. In.
order to be thus included fully 90 per cent, of the deaths occurring in
the State during any year must have been reported and tabulated, and
this information the State Board of Health has never been able to
accurately secure.
Very early in the life of the Board the legislature, on the recom-
mendation of the State Board of Health, enacted a law requiring that
all births and deaths occurring in the State should be reported to the
State Board of Health. Various forms were devised and distributed
for this purpose, and blanks were prepared so that with very little
effort or loss of time tfiose having the knowledge could very easily give
the information. The State Board of Health also offered to pay for
the reports of births and deaths, not^with anything like a large com-
pensation, but sufficiently so to defray postage, and in many instances
postage was furnished. Postcards with the desired information on the
reverse side were distributed to physicians of the State and others from
whom the statute required the reports should come. The effort was
fruitless, but not until after persistent attempts to secure the informa-
tion had failed, did the State Health Officer abandon the plan altogether,
for without entering into legal proceedings, it was found to be an im-
possible task. After giving much thought to it, and carefully weighing
all attendant conditions connected with the subject, the question of
State registration of births and deaths resolves itself into a proposition
like this: If the State desires that Florida shall be included in the
registration area as laid down by the United States Census Bureau, and
the anticipated results from this acquired knowledge would seem to
fully justify the effort and the expenditure of funds, the legislature
must authorize the State Board of Health to obtain these statistics in
some other way than through the practicing physicians of the State,
and the reports must be paid for on a strictly business-like remunera-
tive basis.
Various systems for this purpose are operated in other States, but
in each, to whomsoever makes the report, whether designated as clerk
or registrar, the compensation is such as will bring satisfactory results.
It is estimated that a sum not less than eight or ten thousand a year will
be required to secure these reports with any degree of accuracy if the
data is to be of value after it is collected and tabulated. It is believed
that the information gained will be well worth the effort of the Board
and the investment of funds for this purpose. The State Health Officer
has not felt warranted in operating any plan other than what the
statute prescribed without the sanction of the Board or the authority of
the legislature, but it is thought that if the cities of the State having a
(131)
populaion of two thousand or over would, by requirements of ordinance,
collect reports of births and deaths occurring within the municipality,
fully 30 per cent, of the population of the State would be thus covered,
and" those places making satisfactory returns of this nature would then
be in the registration area of the United States. At present Florida
has only two cities which are in this area — Jacksonville and Key West,
but there is no reason why others should not be.
In the absence of any morbidity reports, it is impossible to say just
how much sickness there was in the State during the past year. Look-
ing at the subject of sickness from the viewpoint of business, it is
believed that a full knowledge of the extent and character of sickness
occurring each week or each month in the State with a statement of
length of time lost as a consequence, would be of very material value,
for the reason that every day's sickness means a monetary loss to the
individual and to the commonwealth ; the greater the number of days
of physical incapacity for labor, the greater the expense to the citizen ;
for every sickness, however trivial, is a burden upon the individual. He
not only loses in his ability to earn, but he depletes his savings already
earned by the drain of numerous extra expenses, which in health would
not have to be met. Therefore, if morbidity information for the whole
State could be had, an increased interest in the subject of prevention of
disease and sickness would be stimulated and the information thus
gained must be of lasting benefit to the people of the State. The value
of birth and death reports is not underestimated. On the contrary,
every report from the Executive Office since the formation of the State
Board of Health has dwelt upon the importance of this feature of vital
statistics. However, the knowledge of factors which disturb the health
of the living and cause prolonged suffering with great monetary expense
is no less important. So that both morbidity and mortality statistics
are equally of great moment to the commonwealth, and repeated efforts
have been made to establish a system and to successfully operate it.
Since the above was written another attempt is being made to col-
lect vital statistics.
Act of 1893 (Chapter 4694), to collect and compile vital statistics,
shows that the State Board of Health is given power to collect vital
statistics through the municipalities of the State. Acting upon this
authority, and after taking the question up with the United States
Bureau of the Census, the following plan was adopted, and is now
being tried :
(a) That the municipality is to appoint a registrar, who is to be
paid for all births and deaths at the rate of 25 cents each by the State
Board of Health, provided :
(b) That standard birth and death certificates as adopted by the
federal government shall be used (these will be furnished to the
municipalities by the State Board of Health without com | ;
(132)
(c) That the original certificates of births and deaths shall be sent
by the municipalities to the State Board of Health, and that a single
copy, in a local register provided by the Board and containing all the
data on the original certificates, be retained as the local record at the
municipal office, the local office to be responsible for the accuracy of
the local records which they retain;
(d) That the number of births and deaths reported shall be within
10 per cent, of accuracy ;
(e) AH municipalities of Florida having a population of 2,000 or
above, shall he qualified to immediately supply vital statistics to the
State Board of Health, and after going into effect, to be admitted to
the registration area of the United States ; all municipalities of Florida
of 1,000 to 2,000 inhabitants shall be next included in this area, and
finally, the entire State.
It is hoped that die towns and cities in the State of 2,000 population
and over may be able to furnish these statistics with 90 per cent, of
accuracy, so that a major portion of the State, anyway, may be qualified
for admission into the Registration area of the Census Bureau.
OF SPECIAL INTEREST TO DOCTORS.
The following report from Dr. Henry Hanson, Senior Bacteriologist
of the State Board of Health, is interesting in two particulars : First,
Dr. Hanson discusses the probability of lessening of time for quarantine
of diphtheria carriers by the use of Lactic Acid Bacilli as a spray, and
second, points out the futility of examination of the artesian water as
productive of carrying media for the typhoid bacilli. The Notes hopes
that the physicians of the State will read this report over carefully and
act upon it, although it is no less important to the general reading
public, as giving information on a subject on which there are so many
confused ideas :
Report of work done in July : The examinations did not indicate
any special prevalence of disease epidemic in the State. We did have
the remnants of a troublesome outbreak of diphtheria in Jacksonville,
but that has subsided at the present time. The principal difficulty
experienced in this was in clearing up the carriers ; that is in securing
negative cultures from those who had had diphtheria and presumably
some who had contracted the diphtheria bacilli, without showing definite
symptoms, from their close association with the patients.
In tliis connection it might be well to mention the discussion on
management of diphtheria carriers as brought out at the Public Health
Section of the American Medical Association. The treatment of bacilli
carriers with the Staphylococcus Auras has been tried out in a great
(133)
many cases. The results in some cases have been good, and, on the
whole, it seems to have cleared up the cases very much faster than the
old methods of irrigating and gargling the throat with antiseptics.
There is, however, an element of danger in the use of the Staphylococcus
spray, viz. : that of a Staphylococcus infection of the sinuses. This has
led many practitioners to be afraid of using this mode of treatment.
Another line of treatment was suggested by Dr. Wood, of Rochester,
Minn., which, if his results can be confirmed, will solve this problem
of the diphtheria carrier. He uses a culture of Lactic Acid Bacilli as a
spray. These bacilli are grown on a plain agar and after a definite
growth is obtained, it is washed off with salt solution and used as a
spray in an atomizer. He sprays this into the nasal cavities and throat.
Dr. Wood reported that where this had been done the patients cleared
up in less than half or one-third of the time which it had taken by other
methods. The great point in favor of this mode of treatment is its
innoxiousness. There is no danger from infection in this form of treat-
ment, since the Lactic Acid Bacillus is not only harmless, but, as you
already know, is used in other forms of medicine, for instance, in
gastro-intestinal disorders, such as diarrhoea, etc. The live organism
is used in both of these forms of treatment.
I have secured culture from Dr. Wood and expect to prepare suspen-
sion salt solutions whenever we come in contact with a troublesome
diphtheria carrier. If we find that this method of treatment will prove
successful here we will no longer have to argue whether or not a carrier
is of great importance, since we can clear such cases up and will not
have to consider the individual who, heretofore, has come in for so much
contention on account of harboring these germs.
We had, during the past month, the unique experience of examining
the brain of a chicken which died with hydrophobia. We found bodies
in this brain which were characteristic and which we diagnosed as
negri bodies. This chicken came from Tallahassee, and was supposed
to have been bitten by a rabid dog.
Another section of our work deserves mention on account of some
statements which were made by Dr. Ravanel in the Public Health
Section at the meeting mentioned above, viz. : the Public Health Labor-
atory and examinations of sputum for tubercle bacilli. Dr. Ravanel
made the statement that, in a way, the public health laboratory was
an impediment in the diagnosis of tuberculosis, because of the large
number of negative reports given on sputa examinations. This, in a
sense, is true but not altogether. I have often thought of this line of
our work and of the unsatisfactory results which we often get. The
trouble here is largely in the nature of the sample submitted and the
responsibility for this rests with the practicing physician to a great
extent. A very large percentage of our samples of sputum are such
that we feel quite certain when we received them, that nothing will be
found in them, and in most of such cases, we do not find the tubercle
bacilli. The physicians usually obtain simply a single expectoration
from these patients, which very often is not coughed up from the
(134)
trachea or bronchial tubes, but is merely a secretion from the naso-
pharynx, and the mouth. Naturally, such examinations do not reveal
anything and a certain number of the practitioners take the negative
report as evidence that the patient is not suffering from tuberculosis but
from some other form of bronchial trouble. If we could, through
Health Notes or some other medium, impress upon the physicians
the importance of securing proper specimens of sputa for examination,
it would largely eliminate this trouble. Also, I think we should impress
upon them the importance of not depending upon a single sputum
examination and the advisability of frequent, repeated examinations in
cases of suspected tuberculosis, especially where the physical findings
are at all suggestive. Dr. Ravanel. however, did not mean to say that
the laboratories should discontinue examining the sputa because that
would result in not making the diagnosis in many cases until the patient
was practically in a dying state, while many have been diagnosed
through the laboratories sufficiently early to give them a fair chance for
recovery. These cases amply justify all the efforts we make in this line
of our work and, in fact, justify us in encouraging more work along
this line, which, I hope, we can make more satisfactory by repeated
suggestions to the various physicians.
In connection with our typhoid work, we find repeated and increas-
ing demands for water analysis without first determining or properly
inspecting the source of the water supply to find whether such case or
cases of fever have any apparent connection with the said water supply.
We have had, during the past month, numerous requests for bottles in
which to send water for examination without any greater reason for the
request than that somebody thinks possibly the water might not be all
right. It seems to me that we might properly require a little more
evidence against the various water supplies before we attempt to go >
ahead with such analysis. I believe that many of the cases in question
are such as that reported by Dr. Dobbs recently, and that there is no
real reason for making the analysis. Would it not be advisable to
require some epidemiological evidence against a water supply before
we proceed with the analysis? And, again, the analysis of water in
such a case does not mean much unless the water is collected by some
person detailed or properly instructed by the State Board of Health. In
many of these cases we would be unable to state what- importance the
results had if they should show fermentation and the presence of bacillus
cob* unless we had collected the water ourselves or it had been collected
by some one whom we absolutely knew to be careful in such work.
JUST WHAT IS ''QUARANTINE" ANYWAY?
That may sound like a simpleton's question, but really what is it?
Can you answer? People often clamor for things not knowing
what they are asking for, and it may be that "quarantine" is sometimes
one of them. A few quarantine laws and customs may throw a little
light on rt. Let us begin with maritime quarantine.
(135)
Under the federal laws, when a vessel arrives from a foreign port
that is infected, it is "in quarantine." No one has to put it in quaran-
tine — it is already there. It comes in flying a yellow flag. Only the
pilot is permitted to board the vessel to bring it in, and he is not per-
mitted to leave it till it is released from quarantine. No one has told
the captain that the vessel was quarantined— lie just seemed to know
and obey. The vessel comes into port flying the yellow flag. And there
it waits till the quarantine physician comes aboard, and examines the
vessel and the crew and, if found satisfactory, releases it. Then the
yellow flag is hauled down, and the vessel proceeds to dock. The thing
to note in this connection is that there is no guard with a gun standing
ready to shoot if the vessel doesn't stop. It is nothing but the majesty
of the law that restrains him. And yet he is in quarantine. He is in
quarantine because the law provides that under these conditions he is
quarantined till released. He doesn't have to have sickness aboard to be
quarantined. He doesn't even have to come from an infected port.
Whenever the law provides that he is in quarantine, he is in quarantine.
But suppose the master of the vessel violates the law, and does not
fly the yellow flag as required by law — does not observe the quarantine,
in other words. Then he is amenable to the law. And no one ever
accuses the government of not quarantining the vessel, we only accuse
the master of the vessel of breaking the quarantine.
Of all the vessels that enter and leave our ports every year, some
coming within quarantine restrictions, and some not, not one guard is
ever employed to keep the quarantine law obeyed. That is quarantine,
as seen by the federal government.
Now let us see what "Quarantine" means in, say, a municipal gov-
ernment. We will begin for example with Altoona, Pa. The regula-
tion says:.
Rule 83. If the diagnosis reveal smallpox, scarlet fever, or diph-
theria, the health officer shall immediately post, in the' most conspicuous
place, on the outside of the residence of the patient, a placard, stating
the name and character of the disease, and warning the public and the
occupants of the house against breaking quarantine. The Board of
Health may, at its discretion, quarantine a house containing a patient
suffering from any other contagious and infectious disease.
That is to say, in the city of Altoona, Pa., when a placard is placed
upon the house, it is in quarantine. No guard — just the majesty of the
law to stand guard, and the house is quarantined. That is quarantine
as seen by a Pennsylvania city.
(136)
The essential point is that quarantine does not presuppose a guard
or guards. That is not a consideration at all. The power that is sup-
posed to enforce quarantine is the law, and the law only.
There is, so far as I am aware, no law that provides for guards.
Certainly not in the U. S. P. H. Service. Certainly not in the State
of Florida,
The question of "guards" then is entirely separate and distinct from
quarantine. Quarantine is a legal procedure. It has behind it the
majesty of the law to enforce it.
When smallpox occurs in a family in Florida, and the State Board
of Health is informed of it, the house is placarded, and the un vaccinated
public is warned against entering, and the patient is warned against
leaving the house. This under the law is quarantine. A patient so
managed is under the law quarantined. If he breaks the law, his action
should be treated as any other infraction of law. He should be pros-
ecuted. And he should be prosecuted by the legally constituted pros-
ecuting attorney of the county in which the infraction occurs. Anyone
having cognizance of the fact should report it to the prosecuting
attorney. It is his business then to prosecute the offender.
"THIS IS ANOTHER WAY TO MAKE GERMS USEFUL".
Speaking of useful germs, it is a fact that they are very, very use-
ful and we would be in a bad way without them. We couldn't make
any wine, or beer, or whiskey, without germs, for that is what ferments
are. These ferments change the sugar into alcohol, and that is called
alcoholic fermentation. We couldn't make vinegar without them, for
that is another process of fermentation. The ferments effect changes
producing acetic acid, and that is called acetic acid fermentation, and
that is the way vinegar is made. Vanilla is made from the vanilla
bean, but the bean has to be fermented, or we would have no vanilla.
Leather can not be tanned, or flax retted but by the aid of germs. Milk
would not sour, and cheese could not be made, but that germs bring it
about. The yeast that is used for making a loaf of bread is a mass of
germs. They attack the starch in the flour and liberate a gas, which
fills the dough with tiny bubbles, and causes it to "rise" as we say. A
disease-producing germ of the gas-producing kind is known and some-
times gets into a wound, and causes the part to swell like the rising
of bread.
But most important of all the germs perhaps is that great group.
which tears down vegetable and animal tissue, after it is dead, and
(137)
nitrifies it, and makes it suitable for plant food again. The amount of
life on the earth is determined largely by the activity of this class of
germs.
PELLAGRA IN THE UNITED STATES.
As there seems to be a confused idea in regard to the increase of
this disease in the United States, and some of the daily press are report-
ing that the Surgeon-General of the United States Public Health
Service has said that it is on a decided increase, the following taken
from the annual report of the United States Health Service, for 1912,
will be interesting to the readers of the Notes:
Pellagra continues present in certain sections of the country. Its
greatest prevalence is in the States south of the Ohio river, and east of
the Mississippi. Cases, however, have been reported in practically
every State. Whether the disease is increasing or not can not be told
in the absence of a record of the occurrence ot cases. Undoubtedly the
disease is being recognized more frequently than in former years, due
to the greater familiarity of physicians with the symptoms. The disease
should he made notifiable in all States, so that its relative prevalence
might he known. Information of its relative frequency of occurrence
in different localities and under varying conditions would undoubtedly
aid materially in determining the cause of the disease.
I'ellagra seems to be largely limited to the tropical and warmer
portions of the temperate zones. Furthermore, it appears to occur
commonly in certain localities which are often limited in extent, and
in some instances have rather sharply defined boundaries. In other
words, the disease occurs frequently in what must be considered well-
defined endemic areas. Whether these areas are determined by the topog-
raphy, the flora, the fauna, climatic conditions or the special manner
of life, or customs of the inhabitants remains to be determined, and
when this has been done the discovery of the cause of the disease will
without doubt be near at hand.
The disease occurs at times in what appear to be distinct outbreaks.
It does not. however, appear to be contagious ; that is, spread by contact
with the sick. The theory is held by some that it is spread by a biting
fly or other insect. This, however, has not been satisfactorily shown
to be so.
In Italy the importance of pellagra economically, and as a sanitary
problem has been officially recognized. In certain sections of the
United States of considerable size the disease is perhaps as serious a
problem as in Italy and as worthy of the most careful study.
'T wish to buy a gift for my husband."
"Yes'm," said the polite floorwalker, "The 10-cent counter is ever
vonder bv the window." — The Pathfinder.
(138)
NEW SEWAGE LAW.
The attention of the readers of the Notes is invited to the following
law enacted by the last legislature — April and May, 1913. It is to be
regretted that "sewerage" is so often used when the word "sewage" is
what is meant, even after the original draft of the measure was cor-
rected, for sewerage is a system for the disposal of sewage which is
the waste material itself :
CHAPTER 6-443 (No. 23), LAWS OF FLORIDA, 1U13.
An Act to Preserve the Purity of the Underground Waters of the
State of Florida for the Protection of the Public Health,
Be It Enacted by the Legislature of the State of Florida :
Section 1. That the term "Underground Waters of the State,"
when used in this Act, shall include all undergrotmd streams and
springs and underground waters within the borders of the State of
Florida, whether flowing in underground channels or passing through
the pores of the rocks.
SECTION 2. No municipal corporation, private corporation, person
or persons, within the State, shall, after the passing of this Act, use any
cavity, sink, driven or drilled well now in existence, or within five miles
of the corporate limits, of any incorporated city or town, or within any
unincorporated city, town or village, or within five miles thereof, for the
purpose of draining any surface water or discharging any sewerage into
the underground waters of the State, without first obtaining a written
permit from the State Board of Health.
Section 3. Every such permit for the discharge of sewerage, or
surface water, shall be revocable or subject to modification or change
by the State Board of Health, on due notice, after an investigation and
hearing, and an opportunity for all interests and persons interested
therein to be heard thereon ; said notice or notices being served on the
person or persons owning, maintaining or using the well, cavity or sink,
and by publication for two weeks in a newspaper published in the
county in which said well, cavity or sink is located. The length of time
after the receipt of the notice within which it shall be discontinued may
be stated in the permit. All such permits, before becoming operative,
shall be fifed in the office of the Clerk of the Circuit Court for the
county in which such permit has been granted.
Section 4. For the purpose of this Act, sewerage shall be defined
as any substance that contains any of the waste products or excrementi-
tious or other discharges from the bodies of human being or animals.
Section 5. Every individual, municipal corporation, private cor-
poration or company, shall discontinue the discharge within the cor-
porate limits or within five miles of the corporate limits of any incor-
porated city or town, or within any unincorporated city, town or village
or within five miles thereof, of sewerage or surface drainage into any
(130)
of the underground waters of the State within ten days after having
been so ordered by the State Board of Health.
Section 6. Any municipal corporation, private corporation, person
or persons that shall discharge sewerage or surface drainage, or permit
the same to flow into the underground waters of the State, contrary to
the provisions of this Act, shall be deemed guilty of a misdemeanor,
and shall, upon conviction, be punished by a fine of twenty-five ($25.00)
dollars for each offence, and the doing of the prohibited Act for each
day shall constitute a separate offence, or by imprisonment not exceed-
ing one month, or both, at the discretion of the court.
Section 7. All laws or parts of laws in conflict with the provisions
hereof are hereby repealed.
Approved June 7, 1913.
THE ART OF KEEPING COOL.
Keeping cool in hot weather is no easy job. In fact, few people can
hold that job down to their own satisfaction. But it is a proposition
that we shall all be up against for the next three or four months, so we
may as well try to make the best of it. Here are some valuable sug-
gestions which have helped others. They may help you.
First of all, don't worry about the hot weather. It is going to come,
and all the worrying you can do will not make it any cooler. Reconcile
yourself to hot weather and nearly half the battle is won.
The next thing to do is to dress for hot weather. Wear light
colored, light weight, porous clothing. Remember that tight clothing
and tight shoes, particularly in summer, are for a few women only.
All men and wise women will leave such things strictly alone.
Plenty of water is really the best thing known for hot weather.
Drink lots of it. Bathe yourself in it inside and out. Drink until you
perspire freely. It is not a disgrace to perspire. It is an aid to health
and comfort. Perspiration on your skin is nature's own way of keep-
ing you cool.
Regulate your diet to fit the season. In hot weather leave off meats,
fats, gravies, butter and other heat producers, and eat fruits and vege-
tables in abundance. By drinking an abundance of water you can keep
your sewer system flushed out. Remember, you never will be comfor-
table, particularly in hot weather, if yoti are constipated. — Press Serticc,
North Carolina State Board of Health.
A little girl had sent back her plate for turkey two or three times,
and had been helped bountifully to all the good things that go to make
a grand Christmas dinner. Finally she was observed looking rather dis-
consolately at her unfinished plate of turkey.
"What's the matter, Ethel ?" asked Uncle John. "You look mourn-
ful. '*
"That's just the matter," said Ethel. "I am mor'n full.— Successful
farming.
"TYPHOID AND THE FLY."
The prevention, even the eradication, of typhoid fever is one of
the most important matters before the people of Florida. The
State has no greater asset than its health fulness and no greater menace
to that health fulness than this insidious disease. Why should hundreds
of lives be sacrificed every year when they might be saved by the
exercise of simple and inexpensive cautionary methods? These
methods are based upon proven facts and common sense.
The disease is spread by flies that carry the germs of infection.
These germs come from persons who have or have had the disease.
They are developed in the intestinal tracts and become available for
distribution from the excreta of such individuals. Flies coming into
contact with such evacuations carry the germs and lighting upon food
leave them there, to be taken into the digestive systems of other indi-
viduals. Disgusting, isn't it?
The germs increase rapidly in their new lodgings and the doctors
soon have another case of typhoid and another source of infection is
started. Recent bacteriological investigations have established the
fact that the conditions most favorable for the breeding of flies exist
in the excreta of horses. The conditions next favoring such breeding
are in the stools of human beings. Where such evacuations are from
typhoid patients, the maggot of the fly becomes infected with the germs
and remains all through its natural life a source of danger.
The warning to be drawn from these facts is that the earth closet
should be so thoroughly screened that the entrance of the fly through
the smallest opening or hole shall be prevented. Guard against the
contamination of the fly at all hazards and then, for the sake of addi-
tional safety, kill him.
It has not been determined how long typhoid germs may remain
in the system of the patient, even after recovery from an attack of
the disease. Cases are on record in which an individual has carried
them in his system for years and has been a constant source of danger
and infection to others, without ever having had the fever himself.
It is certain that weeks, perhaps months, may pass even in the ordinary
individual who has had the disease, before he may cease to be re-
garded as a menace to the community.
As flies migrate of their own accord over long distances or are
carried in railroad trains, automobiles or other vehicles, a single source
of infection may be dangerous over a wide section. It is perfectly
evident that the danger is increased in closely settled communities. It
is equally certain that the danger decreases where the population is
less dense, but nowhere is it a danger to be disregarded.
What is the remedy?
First, prevent the fly from becoming infected.
Next, in the popular phrase — Swat the fly. Kill him wherever you
find him. Keep him out of the house and particularly out of the
kitchen and dining room, where food is prepared or eaten. Keep him
away from foods, especially those that are to be eaten uncooked. N T o
one knows where any fly has been or how terrible a menace he may
be to health or to life itself. Etit the important thing is to prevent
him becoming infected.
In order to do this, screen all earth closets. Screen them so thor-
oughly that no fly can get in through any little opening left carelessly
in putting up the screen. It doesn't cost much to have this work done
properly, and not much to see that the screen is always tight and serv-
iceable. But whatever the cost, it is small in comparison with the
doctor's bill, with weeks or months of lost time and diminished tnergy
and earning power, small indeed, compared with the value of a human
life.
This fo a homely subject, revolting even when it is studied closely
and carefully, but its importance can not be overestintated. It is too
serious to be trifled with, too serious to take any chances on. Neglect
it and you are gambling with life as the stakes, and the odds are
against you. — Press Sennce, State Board of Health.
"Health is one thing that money can not buy." How that has been
hammered into the generations of men ! And now comes science and
says that is not true. The motto of the health department of New York
is this: "Public health is purchasable, and within natural limitations a
community can determine its own death-rate," The Children's Bureau
of the national government agrees. In a recent bulletin it says that in
the last ten years health officers have brought the average death-rate in
cities to a point lower than that in villages. In New York and Phila-
delphia they reduced the mortality among babies by nearly half in those
parts of the cities where they concentrated their work. — Youth's Com-
panion.
"What you need, madam, is oxygen. Come every afternoon for your
inhalations. They will cost you $4.00 each."
"I knew that other doctor didn't understand my case." declared the
fashionable patient. "He told me all I needed was plain fresh air." —
The Pathfinder.
(142)
A BRIEF COMPENDIUM OF PUBLIC HEALTH.
1. Know you that a communicable disease comes only from the
germ of that disease. Kill, therefore, or render harmless the germs
and thou dost prevent the spread of that disease.
2. Sleep with thy windows open, for health and security come with
the fresh air and disease doth lurk in close rooms.
3. Give thou thy body exercise, not in excess, but in moderation,
knowing that thereby thou dost build a wall of resistance against thy
foe.
4. Eat thou in temperance, for thy stomach will rebuke thee if thou
dost overwork it.
5. If thy neighbor has typhoid, have thou not it. But screen thou
thy windows, keep the flies without, boil thy water and eat only those
things that are well cooked.
ii. Remember thou that ofttimes thy water giveth thee the fever.
Protect 'thy water and it will protect thee.
?. The excrement of man spreadeth disease. See thou that thy
privy is safe from flies and that thy neighbor violates not the law.
S. If thy child have diphtheria, think not it can be cured save by
antitoxin, and give thou the antitoxin quickly.
9: If the health officer quarantine thy household, diligently obey
his word, for thou must protect thy neighbor from thy diseases, if thou
wouldst protect thyself from thy neighbor's ills.
10. Give not stale milk to thy baby, for it is poison.
11. Know that the milk thou giveth thy child is clean and fresh
and much care is removed from thy household.
12. Uphold thou the hands of those who would prevent disease,
for they would lengthen the span of thy years and make happy thy lot.
— Virginia Health Bulletin.
STATISTICS.
SMALLPOX,
Reported cases of smallpox in Florida, July, by counties (C65
vaccine points distributed) :
Columbia 2
Duval 3fi
Escambia 8
Hillsboro 3
Lee 1
Manatee 1
Polk 8
Putnam 4
Santa Rosa , 1
St. Johns 5
Total cases, July 71
Total cases to August 1, 1913 1,040
(143)
RABIES.
Report of Rabies in Florida, July, 1913, by counties:
No. persons treated.
Alachua • 2
Duval 4
Hamilton J
Hillsboro 1
Orange 1
Total persons treated 9
Total number of persons treated to August 1, 1913 83
GLANDERS.
Report of outbreaks by counties, July, 1913.
Duval 9
Orange 1
Total number of cases 10
Total cases to August 1 34
In human beings to August 1 1
hoc cholera (Distribution of Senim).
Amount hog cholera serum distributed, July 37,250 c. c.
Amount hog cholera serum reported administered by Agents. July 31,745 c. c.
Number hogs treated, July 1.464
Total weight hogs treated, pounds 95,150
TICK ERADICATION.
During July the following counties were visited by Tick Eradication
Agents of the State Board of Health: Levy, Lafayette. Putnam,
Alachua, Hillsboro, Pinellas.
Cattle dipping vats constructed, July (by counties) :
Alachua 2
Marion 1
Total number of vats' built. July 3
Total number of vats built to August 1 90
SPECIMEN EXAMINATION, BACTERIOLOGICAL LABORATORIES.
Jacksonville. Tampa
Animal Parasites
Diphtheria
Gonorrhea ...
Malaria
Pathological
Rabid Dogs
Tuberculosis
Typhoid Fever
Water (for Sewage Contamination)
Miscellaneous
206
147
281
34
32
41
255
268
6
6
10
2
120
87
182
118
6
41
28
acola.
Total
50
403
24
339
39
112
51
574
12
12
39
246
41
341
1
7
83
152
1,139 731 328 2.1<JS
Grand total number specimens examined by State Board of Health Labor-
atories, July, 1913, 2,1 9S.
0«)
ANNOUNCEMENT.
Dr. Hiram Byrd wishes to announce that he has severed his con-
nection with the State Board of Health of Florida, to become associated
with the management of Grand View Sanitarium for Tuberculosis;
summer home, Newport, Tenn., winter home, Port Orange, Fla.
GOOD NEWS.
Prof. Moore, of the United States Weather Bureau, has discovered
that there is no such thing as an "equinoctial storm." Perhaps we only
think it is storming.
"Smrthers was badly hurt in that trolley smash-up, wasn't he,
doctor?"
"Yerv. We had to amputate both legs."
"How sad ! Will he pull through?"
"Oh, yes ; we'll have him on his feet again in less than three months."
— The Pathfinder,
"Do you keep a cow ?" asked the visitor of small Dorothy.
"No, ma'am," was the reply, "but we keep two cats and a baby." —
The Pathfinder.
Any closet is sanitary that is fly proof.
^V0RI£> 4
Health iMPIotes
OFFICIAL BULLETIN
Published Monthly by the
STATE BOARD OF HEALTH
Subscription 50 cents per Annum
Entered as Second Class Matter, April 20, 1910,
At the Postoffice at St. Augustine, Florida, Under the Act of July 18. 1884.
Vol. VIII September, 1913 No. 9 (£SJ
Hon, Frank J. Fearnstde, President, Hon. S. R. Mallorv Kennedy, M, D.,
Palatka, Fla. Pensacola, Fla.
Hon. C. G. Mem mincer,
Lakeland, Fla.
Edited by
Joseph Y. Porter, M. D., Secretary and State Health Officer.
EXECUTIVE OFFICE AND CENTRAL LABORATORY:
State Board of Health Building,
Springfield Boulevard,
Jacksonville.
branch laboratories:
State Board of Health Building
Florida Avenue and Constant Street, Tampa.
City Hall, Pensacola,
Sent to any address in the State for the asking.
If you receive it without asking, it means that someone else has requested
it for you. . j
When you change your address drop us a card.
When giving change of address, give both the old and the new.
Anything you want to know about the public health we will try to tell you.
Any information you want about communicable diseases of domestic animals
we will help you to get.
Address communications to Jacksonville, Fla.
Screen your house against typhoid and malaria.
DOCTORS OF FLORIDA!
PLEASE READ
This may sound "chestnutty," and some one may also be
inclined to "ring the bell" on the Board, but here goes for one
more time : Please put sufficient postage on the specimen con-
tainers and slide envelopes sent to the laboratories to meet the
requirements of the United States mail. At least six cents should
be put on each container. Failure to do this will cause a "hold
up" and non-delivery at the postoffice, and delay— perhaps, too, a
non-report. It is certainly worth six cents to a doctor to know
whether his patient has diphtheria, malarial or typhoid fever, or
tuberculosis. If you do not intend to prepay sufficiently the
postage, don't complain if you do not get quick service. One day
this past month there were forty-five containers "held up" at the
postoffice for want of sufficient postage, and yet in that same
day's mail several complaining letters were received at the execu-
tive office, finding fault because no report had been made on
specimens sent several days before. The laboratories are ready
and cheerfully willing to assist the Florida doctors, but the doctors
must do their part in the co-operative work and the part that is
requested of them is not to delay reports of their specimens by
insufficient postage when mailing them.
THE COST OF LIFE
It costs more to live than to die.
It costs more, but we considerately call that person insane who
prefers death to life. Disease costs more than health. The sick, the
invalid, are deprived of earning power ; their illness is an expense and
they are a burden to their friends or their families and a continuing
tax upon their sympathies. If a plain statement of the case be not con-
sidered too cold-blooded, death brings an end to their physical suffer-
ing, and it brings an end to the cost of maintaining an unproductive
member of society. The cost stops with death.
Men prefer health and strength, the normal use of their mental and
physical powers, rather than to be deprived of any of them, yet no one
thing is more distressing to the modern sanitarian than the constant
exhibitions of careless disregard of those things that make for health.
Without being or being considered a "crank" on matters of health, it is
possible for any man or woman of adult years to enjoy uninterrupted
use of his or her physical powers at their highest development. Note
(147)
that the limit of these powers is personal to each, for some get a start
in life with the handicap of an inherited weakness or disfigurement, a
punishment put upon innocence for the sins or neglects of preceding
generations. But a kind and wise Providence removes a large percent-
age of these handicapped by inheritance in the earliest years or months
of their existence.
Nature, left to herself, is working constantly to better the race, to
raise the standards of physical perfection. The law of the survival of
the fittest is always in operation among human beings, as among the
animals of the jungle. But this law is almost as constantly thwarted in
its operation among human beings by their stupidity or their thought-
lessness, until the physically perfect specimen of the adult manhood
or womanhood is rare almost to the point of being a curiosity.
Science is working constantly toward the improvement of the race,
and toward making that improvement permanent and universal and
uniform. Medical science is working successfully in pointing out the
causes of disease and how to avoid them. Great as have been its
advances in curing disease, its efforts to prevent it have been even
greater, and they have been of greater value to the human race. It
has worked to reduce the percentage of sickness, to prolong the life
period by safeguarding the normal strength that every individual starts
life with as a part of his equipment, a part of his capital.
But in these efforts the greatest obstacle to advance is the indif-
ference of the pfople themselves. This indifference — carelessness is
another name for it — is almost as dangerous as ignorance.
It needs only to be illustrated to be understood. Medical science
has established beyond the reach of argument, that the germ of typhoid
fever exists in the excreta of those who are suffering from that disease ;
that this germ is carried from this source by the common housefly and
deposited in or upon the food that is to be eaten by other human beings
and that by this process is this dread affliction spread and kept alive in
the human race. The obvious remedy, that of keeping the fly away
from this infection and also away from the food, has been pointed out
and emphasized by the doctors. It has been preached so constantly and
continuously that every intelligent man has heard it a thousand times.
The fact, no longer a theory, has been proved in every community in
the State of Florida.
To reduce this danger in one of the largest cities in the State, its
health department proposed a municipal regulation to screen all surface
closets that, on account of local conditions, could not be destroyed or
removed. The disease had assumed epidemic proportion in one or more
years previously in this city, but the proposed precautionary measure
was fought by the authorities, who believed their own wisdom superior
to that of their trained scientist, until strenuous persistence by the local
health board, backed by the influence of the State Board, brought about
its enactment. The result was the reduction in the number of cases of
typhoid by nearly one-half in the following two years, and incidentally
a lowering of the city's death rate by twenty-three per cent in three
years.
(U8)
There are those, even in progressive Florida, who ridicule vaccina-
tion as a preventive of smallpox, and their criminal responsibility for
promulgating such unbelief varies in proportion to their influence.
There are those in Florida — some of them have known the horrors
of yellow fever and have seen friends, brothers and sisters perhaps,
falling about them to speedy and almost certain death — who repudiate
the belief that the germ of this dreaded disease is carried by the
mosquito, even though the doctors who have taught this theory have
proved its correctness by banishing the pestilence from Florida and the
islands of the Caribbean.
There are some, even among the medical profession of Florida,
who still hold to the long disproved theory that malaria has its origin
in the miasma of foul and undisturbed waters.
There are some who disbelieve in the germ theories of disease trans-
mission—although these theories have been so long and so thoroughly
established that they have ceased to be theories.
It is a question whether there exists a person more to be pitied than
the man of ordinary intelligence, who holds his inner consciousness or
his instinct or his stubbornness superior to the accumulated and in-
creasing knowledge of the scientific world, and who persists in holding
to disproven, dangerous, even death-bringing theories of disease origin.
If there is a man more to be commiserated than he, it is the one who,
with the knowledge of exact sanitary science within his reach — nay,
thrust upon him — goes along his thoughtless way, trusting that a kind
Providence, that has brought him to the years where discretion is
presumed to have had a chance to guide his way, will render him
immune to the working of nature's laws.
The path to health, even though it costs more to live than to die, is
plain. It is being made plainer every day, and the wayfarer, though
he may be foolish, need not stray from it, if he really cares enough
about his life to walk in that way.
The world is growing better; it is growing healthier because the
regard for sanitary methods of living is stronger in the intelligent com-
munity today than ever before, because men take better care of their
bodies, because they are listening more carefully to the warnings of
science. They are taking better care of, are paying more attention to
their physical welfare, and are realizing that without the sound body,
kept sound by observing nature's laws, the mind, the brain is handi-
capped into uselessness. — Press Service, State Board of Health.
READ AND HEED
Florida doctors and other "lovers of the human kind," who value a
human life above that of a dog, please read the following extract from
the monthly report of Dr. Henry Hanson, Senior Bacteriologist of the
State Board of Health, to the State Health Officer, on Central Labor-
atory work:
In connection with the work of rabies, I wish to ask that you again
kindly call the attention of the physicians and the public in general.
(149)
through the medium of Health Notes, to the very' great importance
of not killing a dog as soon as the individual is bitten unless the
symptoms of hydrophobia are absolutely unmistakable. We have had
three unfortunate cases during the past month in which children were
rather severely bitten, the animal killed immediately and the head sub-
sequently sent to the laboratory for examination. In none of these
cases were we able to find Negri* bodies and consequently could not
state that the animal was rabid. The chances are that the animals were
not rabid but there is also the very unpleasant possibility that they may
have been killed at the very onset of the disease and in such case or
cases the brain material of the animals in question would not show
Negri bodies on microscopical examination. The saliva is virulent for
three to ten days before the dog shows definite symptoms of hydropho-
bia and before definite Negri bodies are found in the brain. It, there-
fore, becomes a matter of the greatest importance to urge people not
to destroy such animals immediately. In the cases which we have had
during the past month, the history indicated that several of the dogs
were simply vicious brutes and that they very probably did not have
rabies. However, it leaves us with a disagreeable uncertainty in the
premises and the only absolutely safe course we can pursue in instances
of this kind is to tell the people that the responsibility lies with them
and if they wish to be on the safe side they must take treatment. This
is not comforting advice to give, because the many unfortunate victims
can testify to the painful annoyance of being obliged to submit to the
Pasteur treatment.
For the reasons given we should advise "Do not kill the dog until
you have definite evidence against him u either positive or. negative."'
A dog which has rabies will not live more than three to five days; if a
dog lives ten days after biting you without showing any definite
symptoms, you are absolutely certain that he has not got rabies.
As you notice from the report, we have again been called upon to
witness the death of a human being who died because the cur dog seems
to enjoy a sacred right to roam the streets and- inflict any damage
which he sees fit. This man was bitten on the hand some time ago but
did not take treatment, the dog was not taken up and no examination
was made of the brain in this case. The man died with typical hydro-
phobia.
*Negri bodies are microscopic organisms found in certain portions of the
brain, denoting rabies.
THE MANUFACTURE OF ICE CREAM
(Sanitary Measures in Cuba in Regard to the Manufacture and sale of Ice
Cream. Translation from a Havana Newspaper.)
In view of certain irregularities in the manufacture and sale of ice
cream in several places in this city, Dr. Moralez Lopez was commis-
sioned by the Health Department to undertake a thorough investigation
in regard to everything concerning said industry.
(150)
The above mentioned doctor has presented a detailed recommenda-
tion which has been approved of and is couched in the following terms :
First: All places devoted to the manufacture of ice cream shall be
entirely separated from places devoted to other uses, such as kitchens,
pantries, coal bins, dormitories, and toilets.
Second : The manufacture of ice cream will not be allowed in tene-
ment houses.
Third : The doors and ceilings of places where ice cream is made
shall be thoroughly painted and all walls whitewashed ; the floors shall
be of cement or tile and the walls to be a height of 4^ feet cemented or
tiled. All doors to be screened.
Fourth: The freezers, vats and other utensils used, shall be thor-
oughly cleansed every day before and after using and rinsed in boiling
water.
Fifth : All tables on which extracts or flavors are prepared and
fruit handled shall be of marble in order to insure thorough cleanliness.
Sixth: All fruit stands where ice cream is sold shall be provided
with a sink and running water for the washing of glasses, spoons, etc,
used by the public.
Seventh: Persons employed in the manufacture as well as the sale
of ice cream, must be in sound health and must be provided with a
certificate to that effect.
Eighth : Persons employed in the manufacture or sale of ice cream
shall not be employed in any other class of work while working at the
former. Where wagons drawn by horses or mules are used in sale of
ice cream on the streets the driver or person handling the reins shall in
no case serve customers. All wagons shall be in a thorough state of
cleanliness, should be frequently painted and the name of the owner
plainly shown.
Ninth: Persons employed in the manufacture or sale of ice cream
shall be required to wear clean clothes and to use aprons in their work.
Tenth: All pastry shall be kept in glass jars or painted tin boxes
which should close hermetically, and wrapped in tissue or paraffine
paper in quantities such as are usually sold to each customer, in order
to avoid constant handling.
Eleventh : The public is cautioned to destroy the packages known
as "Glace" once contents have been removed, to avoid their being used
again.
Twelfth: All fruit used shall be sound and ripe and thoroughly
washed before being peeled for the preparation of flavors.
Thirteenth : In order to manufacture or sell ice cream the above
requirements must be complied with and the Health Officers shall issue
certificates testifying to that effect.
Fourteenth : Only such coloring matter as specified in Article No.
53 of the Sanitary Ordinances, will be allowed.
Fifteenth : Violations of the above will be fined according to Article
No. 894.
(151)
TO BE SURE
Another nail driven, clinched and riveted against the opponents of
serum therapy ; in other words, and in plain English the anti-vaccina-
tionists :
There has not been a single case of typhoid fever in the tent en-
campments of 12,000 regulars in Texas during the six months of their
existence. Nor has there been a case of smallpox. To repel these
dreaded diseases the army surgeons have used vaccine. So successfully
have they warred on mosquitoes that only a few cases of malaria have
been reported. There is no pest of flies. If the regulars were ordered
on foreign service they would be sound and fit almost to a man. There
would be no repetition of the horrors of Spanish war camps, so far as
they were concerned. Great credit is due the medical department, be-
cause the only ground available for the camps in Texas was salubrious
neither in site nor surroundings. — New York Sun.
WHY DO MARRIED MEN LIVE LONGER?
The relation between marriage and longevity is not a subject to
which many people give any thought, and yet according to a bulletin
issued by the New York Board of Health, it should prove of keen
interest. Generally, it is believed that those in single "blissedness"
free from all cares and worries should live longer than their married
brethren. This, according to no less an authority than Professor
Wilcox of Cornell University, who is author of the bulletin, referred
to, is not the case. In fact just the reverse. He shows that from 20 to
30 the death rate among married men is 4.2, while among single men
it is 6.6. From 30 to 40 the death rate among married men is slightly
under G, while among single men it is nearly 13. From 40 to 50 there
is an even greater difference. The death rate among married men is
9.5, whereas among single men it is 19.5. From 50 to 60 there is less
divergence in the death rate, but there is a difference in favor of the
married of nearly 11 deaths per year per thousand. Even from 60 to
70 the death rate of married men is less than 32, while that of the single
men is 51.
Reasons for these are no doubt many and varied, the main one be-
ing, possibly, because the married man lives a steadier life.
Professor Wilcox suggests a variety of reasons for the married
man's better chance of longevity. "Undoubtedly," he says, "the lower
death rate among married men is partly due to the fact that as a rule
those who are in good health are ready to marry, while those with
more delicate health especially if suffering from any definite ailment,
are not willing to assume the burden and responsibility of a family.
Another factor quite as surely is that married men live much more
regular lives as a rule, and consequently avoid many of the danger* of
irregular living. Besides feeling their responsibility to others, they do
not take such risks of life or illness and as a rule avoid venturesome
expeditions and dangerous occupations."
(152)
The Macon Telegraph goes further into the statistics and finds that
marriage seems to be a somewhat less certain life preserver in the case
of women. The same statistics show that from 20 to 30 married
women have a higher death rate than single women, the proportion
1 icing about 5 to 4. But the death rate of single women is higher from
30 to 40 as well as for alt the other periods up to 80.
The Journal of the American Medical Association also delves into
another phase of the subject and finds that the mortality rate among
men who have been married, but have lost their wives through separa-
tion or death, is greater than among married men or among bachelors.
"Indiscretions incidental to repeated celebrations of liberty re-
gained ?" would be the easy query of the cynical bachelor or divorced
men. But in the opinion of the Journal of the American Medical
Association there is a positive influence for longevity in the supervision
of a married man by his wife, and in his tendency to take better care
of himself because of his having responsibilities, than he would if he
were unattached. Therefore, "the man who loses his wife, loses, in
part, his hope of longevity." — Key West Morning Journal.
A NOTE REGARDING THE APPARENT CURE OF
TWO LEPERS IN MANILA
Two patients who had been confined to the San Lazaro Leper
Hospital on account of leprosy have been pronounced apparently cured
and discharged from that institution on probation.
The first case was that of a male Filipino, aged 27, who was
admitted to the San Lazaro Leper Hospital, Manila, May 29, 1909.
On admission the case clinically showed thickened reddish spots On the
nose and thickening and discoloration of the lobe of the right ear.
Scrapings made from the lesions showed lepra bacilli. He received
vaccine treatment at intervals, beginning August, 1909, but at the
expiration of one year no change was noted in his condition. From
September, 1910, to November, 1910, crude chaulmugra oil was given
by mouth in increasing doses. On account of nausea the administra-
tion of the oil by mouth had to be discontinued.
The case showed evidences of improvement. On November 10,
1910, chaulmugra oil combined with oil of camphor and resorcin was
given hypodermically. By May 6. 1911, the lesions above described had
disappeared and leprosv baeiili were not found in repeated micros-
copical examinations. *The hypodermic treatment was continued and
microscopical examinations were made at frequent intervals, but these
were always negative. On June 11, 1913, a most careful clinical and
microscopical examination was made of the patient, which resulted
negatively for leprosy, and as the patient had now been apparently
cured for a period of over two years he was discharged on probation.
The other case was that of a Filipino woman, aged 22, who was
admitted to San Lazaro Leper Hospital, Manila, January 7, 1910.
Clinically this patient presented a suffused countenance due to general-
ized infiltration. There were red macules over the cheeks, forehead
(153)
and chin. Scrapings made from the lesions and examined microscop-
ically were positive for leprosy bacilli.
Upon admission this patient was placed upon the vaccine treatment
for a period of five months, but at the end of the first month after her
admission crude chaulmugra oil by mouth was given in addition to the
vaccine.
After the second month the patient began to improve rapidly, and
on May 6, 1911, leprosy bacilli could not be found on microscopical
examination. During May, 1011, on account of the nausea caused by
the oil, its use by mouth had to be discontinued. Hypodermic injec-
tion of chaulmugra oil combined with camphor and resorcin was then
begun. This treatment was continued, and frequent microscopical
examinations were made from time to time, all of which resulted nega-
tively. The last examination, both clinical and microscopical, was made
on June 11, 1913, when no further evidences of leprosy could be found.
The patient was therefore discharged from the hospital on probation.
It is not known whether the vaccine treatment had any influence
in the cures. There are at present time a number of other cases at the
San Lazaro Leper Hospital that have been negative for a period of 22
months, which, upon admission, presented more marked evidences of
leprosy than the cases mentioned above, yet they received only chaul-
mugra oil either by mouth or hypodermically, or in both ways. — Victor
G. Heiser, M. D. r in Public Health Reports, September 5.
THE BIOLOGY OF SEWAGE PURIFICATION AND THE
FUNCTION OF THE SEPTIC TANK
(By George T. Palmer, B.S., Sanitary Research Laboratory of the
Massachusetts Institute of Technology.)
So extensively has the septic tank been advertised as a method of
sewage disposal within the past few years that the mistake is apt to
be made of regarding this process as a complete and satisfactory
method in itself. A slight familiarity with the exact function of the
septic tank will readily convince one that such is not the case.
Let us first understand the purpose of any sewage disposal method.
Sewage is merely that portion of a community's waste matter that is
carried away through underground sewers. While street wash, waste
water from sinks and bath tubs, and manufactured wastes are generally
present in a city sewage, the offensive element is partially decomposed
urine and feces from man and animals. Matter of this character is
odoriferous and repugnant to the senses of sight and smell. Further-
more, it may contain the germs of disease from the bodies of people
contributing to the sewers.
For these three reasons, therefore, sewage must be taken care of,
(1) so that the disease germs will not have opportunity to come in
contact with man and animals, (2) so that the smell will not reach
populated districts, and (3) so that the characteristic paper and sedi-
ment will not betray the former associations of the liquid.
Fine screens or sedimentation basins will remove the coarser
material that offends the eye and gives sewage its muddy appearance.
(154)
The smell may be obliterated by oxidizing the offensive matter.
Free access of air is therefore provided by letting the sewage trickle
over several feet of crushed stone, clinker or any coarse, not easily
broken or soluble material. Or sewage may be run through sand where
active oxidation is assisted by some straining action. The sewage may
even be sprayed into the air or have air bubble through it.
The diseased germs are partially removed during the various proc-
esses just mentioned, but to reduce their number to a minimum and
make the sewage effluent as low in bacterial numbers as the body of
water into which it empties, some very fine straining method must be
used or else a substance added that will act as a poison to the germs.
All sewage disposal plants are, therefore, designed to accomplish
these three objects to some degree, and the ideal plant is one that will
remove the suspended matter, oxidize the soluble matter, and kill the
disease germs.
It would necessitate a vast amount of tabulating to record the
various devices and combination of devices now in use in sewage dis-
posal practice. It is safe to state, however, that no two communities
have identical systems, either in the devices used or in the degree of
purification effected.
Just what part does the septic tank play in the purification problem ?
The septic tank is merely a container that facilitates the septic process.
This septic process consists in bacterial activity in the absence of oxygen
resulting in the conversion of solids to liquid. When sewage is left to
stagnate, the oxygen dissolved in the water is first used up in burning
(oxidizing) the simple carbonaceous and nitrogenous matter present.
Sewage in the first place is not a simple substance, but must first be
eaten and split apart by the bacteria. In passing through the bodies of
the bacteria it is more elementary than when it entered. Similarly
human excrement is more elementary in character than the food that is
eaten. The first group of bacteria passes the food on to another group
which in turn selects desired materials and then passes it on to the next
class. As this material becomes less complex it more readily unites with
oxygen either to be "burned" and pass into the atmosphere as a gas,
or to remain in solution as a carbonate, sulphate or nitrate. Solid
matter thus is partially changed over to a liquid and gaseous condition.
But why is it necessary to exclude oxygen during this process? As
long as the matter must eventually be oxidized, why not give it all the
oxygen it can stand and as fast as it can be used? Because there are
types of bacteria which can not do this destructive work in the presence
of oxygen. Human beings do not thrive in the presence of carbon
dioxide or ammonia. A hot, sultry day is depressing whereas a cold,
clear day is exhilarating. The hot sultry day is to the human being
what an excess of oxygen is to these particular bacteria. Consequently,
it behooves us to make their surroundings conducive to their best
efforts.
To be sure, oxygen must be supplied to this broken down organic
matter, but this must be delayed until the bacterial laborers have finished
their work on it and have brought it to the stage where the finishing
(155)
touches can be applied. Emphasis must be laid on the fact that this
"breaking down" action of the bacteria means both a physical and a
chemical destruction. Coarse matter becomes finally divided, and
complex chemical substances become changed into many elementary
ones.
After the oxygen in solution unites with the simplest organic mate-
rial, the oxygen in combination with other elements, such as nitrates,
sulphates, etc., is loosened to unite with matters that will gasify and
leave the liquid, as carbon dioxide and carbon monoxide.
When the available oxygen has been practically eliminated from
the liquid, then a septic or putrid condition exists.
The danger of an overseptic condition must be warned against.
Much better is it to shorten the digesting period rather than prolong it.
In a tank where the bottom deposit is constantly washed by the incom-
ing sewage and toxic or poisonous substances thereby prevented from
accumulating, a semi-septic stage is most satisfactory, as a number of
destructive bacteria which require some oxygen can also labor here to
advantage.
Consequently, the scum formed by the lighter suspended matter
rising to the surface is not necessary to the successful septic tank and
actually becomes a source of trouble by growing large enough to mate-
rially decrease the capacity of the tank.
Food
Plants
Animal Life
f
Miner;]! Sol ul ions
Eser»*ta
Bacteria <^"^
The ideal condition exists when the inorganic matter only is depos-
ited in the bottom of the tank and the finely divided organic matter is
constantly passing out in the effluent. Shorter storage periods will
accomplish this result and accumulating sediment is thereby reduced
to a minimum.
To better understand the changes undergone by organic matter in
its decomposition and the part played by bacteria, reference may be
made to the diagram representing the "cycle" of "organic matter."
Man and other animals eat food and convert it into excreta, a much
less complex condition. Bacteria eat this excreta as their food and
make it over into mineral solutions. Plants feed upon this mineral
(156)
matter and thereby build up their own body tissue, which becomes food
for animals.
Thus animals, bacteria, and plants mutually assist each other in
their struggle for existence.
If animal life were eliminated from the earth, bacteria would have
a difficult time in finding easily digested food. Untouched by man,
horse, earthworm, etc., plant life would be coarse fare for bacteria.
Eliminating bacterial life would be fatal, however, as plants are absol-
utely unable to live upon animal-food or excreta. Their nourishment
must of necessity be in a mineral form. Now, if we suppose the earth
to be deprived of all plant life, then animals would have to live on each
other which would soon result in a speedy depopulation of animal life
beginning with the smaller and weaker forms.
The septic tank, then, is a destructive furnace or a disintegrator. It
demolishes complex organic matter making it into simpler chemical
substances. It has a mechanical action in converting bulky matter into
a finely divided state and partially into solution. It kills out some of
the disease germs that enter.
If successfully operated, therefore, a septic tank makes sewage less
obnoxious to look upon. On the other hand, it intensifies the smell and
has little effect on the germs.
Obviously the septic tank is not a complete process in itself. It is,
however, a good preparatory school. Its products are crude and un-
finished but promising. Additional training meets receptive ground
and progress is rapid.
To run a septic effluent of considerable volume into a small stream
would befoul the stream and enormously increase its bacterial content.
Added to a large stream, the effluent would undoubtedly find sufficient
dissolved oxygen in the water to subdue its odor, but even here with
great dilution, the disease germs are being added to the water in large
numbers, and communities so doing are menacing the health of others
below who come in contact with the waters of the stream.
Septic sewage taxes the oxidizing power of a stream more than an
equal amount of untreated sewage because of the rapidity of its union
with oxygen. Unless the stream is well supplied with oxygen, this
sudden severe drain will exhaust the oxygen present. Crude sewage
requires as much oxygen eventually but because of its less decomposed
state it does not take it up so readily. Particles of crude sewage may
be carried along for twenty hours before uniting with oxygen. Septic
sewage would more likely combine with oxygen in the first half hour
of its passage.
Besides disposal into a body of water not used for domestic purposes,
there are two other courses open for the final disposal of the effluent.
It may be applied either to agricultural land or to an artificial filter bed.
If the fertilizing value of the effluent is to be made use of, then
vegetables and fniits for human consumption must not be grown on
the land for fear of contamination by disease germs. Nut trees and
fodder can probably receive the effluent with impunity. Truck gardens
(157)
may be fertilized, however, by subsoil drains properly laid within a
foot or so of the surface of the ground.
If the effluent is small in quantity a filter bed of coarse material is
out of the question because of the necessity for a continuous flow. A
loose, sandy soil is the only recourse for the small disposal system.
Here the intermittent flow is advantageous, and. in fact, necessary.
Filtration through two or three feet of sand very satisfactorily
completes the purification problem. The unstable, odorous and germ
laden septic effluent is here oxidized, made presentable to the most
fastidious sense of smell, and largely robbed of its bacterial wealth.
STATISTICS
SMALLPOX.
Reported cases of smallpox in Florida, August, by counties (240
vaccine points distributed) ;
Alachua
Brevard 1
Dade 9
Duval ■ . 3
Escambia 3
Lee 3
Putnam 1
Total cases, August ■ 29
Total cases to September 1 ( 1913) 1,069
RABIES.
Report of Rabies in Florida, August, 1913, by counties :
Xo. persons treated.
Duval 5
Hillsboro ■ 1
Total number persons treated 6
Total number persons treated to September 1 (1913) 91
Deaths from hydrophobia. August (Jacksonville) 1
Total deaths from hydrophobia lo September 1 (1913).. 3
GLANDERS.
Report of outbreaks by counties, August, 1913 :
Duval .'...... 7
Seminole 1
Total number of cases - 8
Total number of cases to September 1 (1913) 42
HOG Cholera (Distribution of Serum).
Amount hog cholera serum distributed, August 47,750 c. c
Amount hog cholera serum reported administered by Agents, August.. .21.630 0. c
Number hogs reported treated, August 923
Total weight hogs treated, pounds 62,300
TICK ERADICATION.
Counties visited by Tick Eradication Agents of the State Board of
Health, August : Sewanee, St. Johns.
icola
Total.
47
403
40
201
28
112
S5
462
3
17
* *
11
31
201
42
313
3
19
88
129
(158)
Cattle dipping vats constructed, August (by counties) :
St Johns . . 1
Total number vats built to September 1 21
SPECIMEN EXAMINATION BACTERIOLOGICAL LABORATORIES.
Jacksonville. Tampa. I
Animal Parasites 200 1S6
Diphtheria 179 42
Gonorrhea 32 52
Malaria 199 208
Pathological a 5
Rabid Dogs 10 1
Tuberculosis 104 66
Typhoid Fever , 174 97
Water ( for Sewage Contamination) 16
Miscellaneous 28 13
951 640 337 1,928
Grand total number specimens examined by State Board of Health Labor-
atories, August, 1,928.
Specimen Examination, Bacteriological Laboratories (Positive)
August, 1913,
REPORT OF CENTRAL LABORATORY, JACKSONVILLE, FLA.
POSITIVE MALARIALS.
( Including)
Tertian. Aestivo-Autumnai. Quart ian,
Jacksonville IT 8
Mandarin 1
Ocala 3 1
Titusvitlc 1 . . 1
Greensboro 1 1
Greenville - 1 1
Tallahassee 1 1
Daytona 1
Hosford 1 . . 1
Orlando 1
SB 11 3
POSITIVE WISALS.
(Typhoid Fever.)
Jacksonville 14
Worthington 1
Tallahassee 4
Lulu 1
Dowling Park , 2
Lake Butler 2
Holder 1
Wauchula 2
Green Cove Springs 1
Greenville 1
Dade City l
Delray , 1
31
(159)
POSITIVE DIPHTHERIA.
Jacksonville , 7
New Smyrna 1
Gainesville 4
Tallahassee 4
Ocala 1
Lake Butler 1
Morristown 1
Branson 1
Delray 1
DeFtmiak Springs 4
Caryville 1
26
POSITIVE TUBEBCUXOSIS.
Jacksonville : 10
Lemon City 1
Welaka , 1
Orlando , 3
Grantlin 1
Tallahassee 1
Kissiromee 1
Miami 1
Leesburg 1
Gainesville 1
Emporia 1
Key West 1
Port St. Joe 1
Dade City 1
23
POSITIVE RABIES.
Jacksonville (including 1 human, 1 cat) 5
Trenton - 1
6
PROGRESS OF VITAL STATISTICS IN FLORIDA
The following cities, of 2,000 population and above, are reporting
births and deaths to the State Board of Health : Jacksonville, Tampa
(with West Tampa), Pensacola, Lake City, St. Petersburg, Ocala,
Orlando, Lakeland, Sanford, DeLand, Palatka, Marianna.
The following cities have recently appointed registrars, are now
formulating ordinances for collecting reports, and expect to submit
birth and death reports to the State Board of Health in the near future :
Femandina, Ktssimmee, DeFuniak Springs.
The cities given below have city health departments, and will sub-
mit death and birth reports to the State Board of Health soon : Gaines-
ville, St. Augustine, Key West, Miami (now organizing).
The following cities have, upon being interviewed by Assistants to
State Health Officer, signified their intention to take the matter of vital
statistics up at next council meeting, with a view of submitting reports
to the State Board of Health: Live Oak, Plant City, Bartow, Fort
Myers, Tarpon Springs.
(160)
The following cities yet remain to be visited in the interest of vital
statistics : Tallahassee, Quincy, Apalachicola.
The city of Daytona has an ordinance making compulsory the re-
porting of births and deaths, and the appointment of a registrar is be-
ing considered.
A RETORT COURTEOUS
It is not often that newspapers contain such a rich piece of humor,
although to the parties concerned it may seem far from it, as that
which appeared recently in the Ithaca (N. Y.) A T eius. This was but
another case of domestic infelicity and the story was told in two small
advertisements, one appearing a day ahead of the other. They read:
Notice: My wife, Alice Stephens, has left my bed and board with-
out just cause or provocation, and I hereby give notice that I will pay
no bills of her contracting, Jas. Stephens, Ithaca, \\ Y., dated June 23,
1913.
Notice: I wish to inform the public that the statement of James
Stephens of my having left his bed and board is an untruth, he having
no bed to leave and I having provided nearly all the board. Mrs. Alice
S teph ens . — Mi am i Metropo lis.
■ Over 200 persons in Florida have taken anti-rabic treatment through
the State Board of Health since January, 1912.
Death rate for Tampa and West Tampa per year per thousand
based on report of deaths for July and August, estimating the popula-
tion at 65,000, would be 14.8.
Three persons taking Pasteur treatment last month were supposably
infected with hydrophobia from a human being.
Fewer cases of smallpox were reported for August than for any
month of the current year.
Forty people, in Jacksonville and vicinity, have been bitten by mad
dogs so far this year and have taken the Pasteur treatment.
A man living near Jacksonville recently received a small scratch on
his hand from the tooth of a dog, but did not take Pasteur treatment.
He died from hydrophobia a few weeks later (in August). Another
death from hydrophobia occurred in Jacksonville September 13th : tfefe
man, also, neglected to take Pasteur treatment.
^ORto 4
Health
Notes
OFFICIAL BULLETIN
Published Monthly by the
STATE BOARD OF HEALTH
Subscription 50 cents per Annum
Entered as Second Class Matter, April 20, 1010,
At the Postoffice at St. Augustine, Florida, Under the Act or July 16, 1894.
Vol. VIII
October, 1913
No. 10 (££.)
Hon. Frank J. Fearnside, President, Hon. S. R. Mauory Kennedy, M. D.,
Palatka, Fla. Pensacola, Fla.
Hon. C. G. Memminger,
Lakeland, Fla.
EDITED BY
Joseph Y. Porter, M. D„ Secretary and State Health Officer.
executive office and central laboratory !
State Board of Health Building,
Springfield Boulevard,
Jacksonville.
BRANCH LABORATORIES !
State Board of Health Building
Florida Avenue and Constant Street, Tampa.
City Hall, Pensacola.
Sent to any address in the State for the asking.
If you receive it without asking, it means that someone else has requested
it for you.
When you change your address drop us a card.
When giving change of address, give both the old and the new.
Anything you want to know about the public health we will try to tell you.
Any information you want about communicable diseases of domestic animals
we will help you to get.
Address communications to Jacksonville, Fla.
"The registration of vital statistics is the Arm basis on which the whole struc-
ture of sanitary science and practice must rest." — Dr. Charles V. Cliapin.
(162)
COLD WATER BATHS.
Some one asks every now and then : "What about cold bathing ?
Are cold baths healthful or harmful ?" That depends on the individual.
If, after a cold plunge or bath a glow comes out on the skin and a com-
fortable feeling of heat follows the "drying off," then the cold bath
has done good. If, on the other hand a shivering feeling comes after
the cold bath and instead of a pink glow all over the body, a blueness
and "goose flesh" is a sequence, then the cold bath is harmful and
should be avoided — never taken. Thus individual peculiarities must
govern a habit or a taste, whatever it may be called — of this kind. A
cold bath or plunge only does good when there is an exhilarating effect
following the act. It is positively dangerous otherwise. Another ques-
tion to answer. Why dangerous ? Because of the shock to the system
and the depressing action on the organ of circulation, the heart. A
sudden shock may through a paralyzing action arrest the heart's action
— a nervous phenomena but a fatal one nevertheless, and when the
heart stops beating we all know what follows.
************
But to those who can, without danger and injury, indulge in cold
bathing, there is a most delightful sensation after coming out of the
tub. The skin fairly tingles with the red blood coursing rapidly
through the capillaries and little arterioles, and it is said by those used
to this luxury, that the effect is similar to champagne without the un-
pleasant head symptoms of a "cold bottle."
Cold bathing daily, of the neck and shoulders, renders a person less
liable to "take cold" and drafts of air usually thought to be so danger-
ous pass over without damage to health. To answer this query, Why?
Because, from daily accustom to cold, the nerve filaments of the skin
are not so acutely sensitive to cold air or to cold in any form and do
not exert that constrictive action on the smaller capillaries of the skin,
producing a congestion of the interior with a marked diminution of
blood pressure on the surface of the body. It is only when there is a
lack of equilibrium between the blood pressure of the surface and
immediately below the surface, under the skin, that the danger of "tak-
ing cold" threatens.
WHAT IS A DOG WORTH?
Which is worth more, a man or a dog ?
Perhaps some dogs are more valuable than some men — that is a
matter of opinion — but on the basis of general averages, what is the
answer ?
(163)
At the -risk of wearing holes in a subject already threadbare, the
State Board of Health is again calling attention to the existence of
rabies in Florida, and particularly in Duval County. The significance
of the repetition is emphasized by the recent death of a human being in
Jacksonville, the third within the past six months, and the second within
one month from this disease.
Is there any basis for estimating the dollar value of a human being ?
The courts have fixed it in individual cases high in the thousands of
dollars. But, place the average per annum earning capacity of men at
nine hundred dollars; that is six per cent on fifteen thousand dollars.
Twelve hundred dollars is six per cent on twenty thousand dollars.
Whatever the probable earning capacity may be, the commercial value
of the average adult male, the most productive of any class of the hu-
man race, would vary somewhere between these figures. Some are
worth vastly more ; some, by this standard, are worthless.
What dog has an actual commercial — not a sentimental — value of
twenty thousand dollars ?
Reverting again to averages, the actual worth — again, not the senti-
mental worth — of a dog is about what his hide would bring in the
markets, and fifty cents might be an overestimate. And yet every com-
munity, particularly every rural section, harbors or permits the exis-
tence of a lot of fifty cent dogs as a continuous menace to the life of
every twenty thousand dollar man in the neighborhood, and when the
authorities make a consistent effort to protect human life, public senti-
ment protests against and nullifies such effort.
There are few public health measures which have met with as per-
sistent opposition as have the efforts aimed at the eradication of rabies.
There is no disease that causes greater agony than this. There is no
disease that is more easily preventable, when the people of the com-
munity will allow the health authorities to prevent it. Only two simple
measures are necessary — a license tax which is actually enforced, and a
muzzling ordinance.
There are some things that the people of Florida may have free,
without even asking for them. Hydrophobia is one, and from the
official reports it would appear that Floridians not only want, but
actually crave this dread affliction. And this somewhat peculiar
attitude has been, in some instances, fostered by the newspapers of Flor-
ida, which have led public sentiment in its opposition to dog muzzling
laws and their strict enforcement, Florida probably is no worse and no
better than other Southern States in this respect.
What has hydrophobia cost the State of Florida in the last ten years ?
Nineteen human lives, thirteen of them in the last two years.
As to the money cost, the figures are not so easily obtainable, but it
is known that the cost in Duval County alone has been more than fifteen
thousand dollars in the past thirty months, in the loss of horses, mules,
valuable high-bred dogs and other domestic animals. This amount
would be largely increased if similar statistics were available from other
parts of the State,
(164)
There is another feature of this financial expense to the State.
Through its Board of Health, Florida provides the Pasteur treatment
for hydrophobia patients. It furnished this treatment for one hundred
and fifteen such patients in 1911 ; for one hundred and fourteen in 1912,
and for fifty-three in the first four months of the present year. The
State began this service in 1908, and to the first day of May, 1913, it
had paid from its funds nearly ten thousand dollars in this way —
$9,675.00 to be exact. And not one cent of this amount has come-back
to these funds. Other expenses connected with this treatment more
than doubled the amount, and so it is safe to say that each of the three
hundred and eighty-four dogs which caused this danger, cost the State
close to fifty dollars, a hundred times more than their value by the most
liberal estimates.
It is not the high-bred, valuable hunting dogs that are to be feared
as a source of rabies, if the community will take care of the worthless
cur that hasn't even a sentimental value. If any section can be rid of
the homeless, wandering mongrel, the disease may be controlled or
wiped out. But it must be remembered that any dog with this infection
is always a menace, whether its value be a hundred dollars or a hundred
cents. And the animal which is kept about the house or in the kennel is
the more dangerous because of its closer and more constant association
with human beings.
There can be no doubt that Florida, more easily than any other State,
might be rid of this disease. It could eradicate it. England used to
have it, but the persistent enforcement of effective muzzling laws
brought about its banishment, and equally effective quarantine has kept
it out. Australia never has known the disease, because its government
profited by the experience of other countries and never permitted the
infection to come in. Once Florida had eliminated the disease, it could
keep it out more easily than any other commonwealth, for it can guard
its coast borders more effectively, and it has comparatively small land
border in addition to protect.
To secure efficient service in this direction, the enactment of dog
muzzling laws is necessary, whether by municipal, county or State au-
thorities, but the enforcement of such laws should be transferred to
local or State health authorities. Those who are charged with the pro-
tection of the public health enforce the laws under which they act with
a nearer approach to absolute impartiality than do political officials,
whose duty often involves the enforcement of ordinances that are con-
trary to public sentiment. Health boards act with less regard to such
sentiment. They speak with a stronger appeal to this same public senti-
ment, because there is a rather general belief that they have substantial
reasons for what they say and do.
These same health boards are given authority for energetic and
sometimes drastic action in protecting the community against the invas-
ion of yellow fever, smallpox and other infections. The death rate in
a number of yellow fever epidemics has been close to ten per cent of the
cases of infection ; in smallpox it is smaller, perhaps almost negligible,
(165)
but the records show that the usual and natural death rate from rabies
among human beings is sixteen in each one hundred cases. The Pasteur
treatment has actually reduced this rate to one in each one hundred.
But it remains a disease with fatal possibilities ; it is a menace to human
life and happiness. Municipal control of this situation, with rare excep-
tions, has proved a farce.
What is Florida going to do about it ? — Press Scnnce State Board
of Health.
ADVICE REGARDING COLLECTION OF BLOOD
SPECIMENS FOR MALARIA.
Dr. Henry Hanson, senior bacteriologist of the State Board of
Health, in submitting his report of the operations of the Central Lab-
oratory at Jacksonville, makes some pertinent remarks in regard to blood
specimens sent for examination, which the doctors and public in gen-
eral of Florida will do well to note and to follow the advice given :
One of the difficulties encountered in rendering a satisfactory ser-
vice to the people of the State is largely in the examination of speci-
mens of blood for malaria. It is almost a daily occurrence to receive
specimens from cases where quinine has been administered in palliating
doses. The difficulty in finding the Plasmodium in cases where small
doses of quinine have been administered is very great indeed and can
only be appreciated by a person who has spent years in a public health
laboratory in a subtropical country of this kind. As a Rile we do not
find parasites in these cases. I have often wondered what the remedy
might be in instances of this kind and have concluded that we probably
can not entirely eliminate the difficulty.
The tendency in this section of the country ii for everyone to take
quinine as soon as one feels at all badly. The people in general,
throughout the State, will take varying amounts of the many and
varied chill tonics which are advertised everywhere and for sale by all
drug stores in the State; When these do not clear up the condition, a
physician is called and he often administers more quinine. From a
large percentage of these cases we get blood smears and our results are
naturally negative for malarial parasites. Some of these cases are un-
doubtedly malaria ; many of them are not. In order that there may be
more uniform and correct results reached in this line of the work, I
trust that we can suggest to the physicians and the public in general,
through the medium of Health Notes, that a little co-operation may
very materially aid in correcting the discrepancy between the number
of positive and negative reports for malaria. To the patient who feels
badly and thinks that he may have malaria I would suggest consulting
his physician. Of the physician I would ask that several blood smears
be taken, when he first sees the patient, and these be sent to the labor-
atory. It may be advisable to take one or more thin smears, such as
has been our routine practice, and one thick smear. For the thick
smear a fair sized drop of blood should be collected and spread out
(168)
evenly to cover about from one-half to three-quarters of an inch square
on the slide. After these specimens have been secured it is not always
practicable or advisable to wait for the laboratory report and in cases
where it seems urgent to give the quinine the drug can then be admin-
istered and confirmation of the diagnosis be received later.
It is true that a few discrepancies will come up between the clinical
and the laboratory diagnosis, but they will be materially less than in
the past. Where the clinical diagnosis is not absolutely established as
malaria it is advisable to wait for the laboratory report since the ad-
ministration of quinine in such cases will certainly obscure the course
of the disease and put the patient to the annoyance which quinine
usually occasions.
SUGGESTIONS TO PHYSICIANS WITH REGARD TO
LABORATORY SPECIMENS.
By W. A. Claxton, M. D., Assistant Bacteriologist State Board of
Health.
(Read before Duval County Medical Society.)
The intelligent physician of the present day is coming to place more
and more dependence in laboratory findings as an aid in the diagnosis
of many diseases, and laboratory workers are continually discovering
new methods by which certain pathological conditions, which hereto-
fore could only be classified by clinical symptoms, may now be definitely
diagnosed by one or more laboratory methods.
The object of this paper is to attempt to point out some of the ways
in which the physician can aid in making the examination of the various
specimens more satisfactory and thereby make these examinations of
more benefit to the physician, the patient and the laboratory worker.
This is to be accomplished in two ways :
First. In giving all the information possible about the specimen.
Second. In submitting the specimen in such a way that it is most
easily given a fair and complete examination in the laboratory.
I will now take up the specimens received in the laboratory and try
to outline the correct manner of submitting them and also point out
some of the mistakes which so often come under our notice.
In the first place, it is best to use always the correct blanks for the
various kinds of specimens, as in that way there is not the extra work
of copying the data from one blank to another. There are always
plenty of blanks and containers to be had for the asking, and the aver-
age physician is generally not too busy to fill these out. Besides, the
questions asked on one blank apply to that particular disease and the
information that a patient has or has not had ground itch, or has or has
not lived outside of Florida, while of statistical value in regard to feces
work is not an important piece of information when a specimen of
sputum is submitted, while the duration of the disease in tuberculosis is
rather a desirable thing to know.
(167)
Taking up the specimens submitted for diagnosis separately we will
first consider malaria*
In this laboratory we prefer the blood taken in the thin smear.
When a thick smear is sent in it should always be accompanied by an
even thin smear. The best way to make these is to take a small drop
on a clean slide about half an inch from the end. Then, placing the
end of another slide in this, allow the blood to spread along the edge
of the end of the slide by capillary action; next holding the slides at
an angle of forty-five degrees to each other, push the second slide to-
wards the other end of the horizontal slide. This has the advantage of
giving a thin, even smear and does not tend to cause the white cells to
be massed at one end of the slide as is the case when the slide is pulled
instead of being pushed. By making the angle of the second slide less
than forty-five degrees the smear will be thinner and by increasing the
angle the smear will be thicker. If the first attempt is not successful
the slides may be cleaned with alcohol and dried and a second smear
taken. Other methods consist in using a needle or cigarette paper, or a
thin piece of rubber or glass tubing. Of these the cigarette paper is
easiest and most satisfactory. This consists in using a piece of cigarette
paper and spreading the blood by drawing it along the slide and is of
value where the specimen is brought in on a piece of glass such as win-
dow glass. Another thing to avoid is allowing the slides to be brought
together before they have dried. This destroys the desired smooth sur-
face and renders a fair examination impossible. They should be allowed
to dry in the air, which takes only a moment if the smears are thin
enough, and placed in the containers with the smeared surfaces opposite
each other.
Inasmuch as blood for typhoid examination often accompanies the
smear for malaria I will mention that it should be on a separate slide,
as having them on the same slide interferes with and delays both
examinations and occasionally the blood for the widal test becomes lost
or destroyed. Also the blood for the widal test should be in the form
of a drop and not spread in a thin smear. Where a glass slide is not
available for collecting blood for a widal test a drop may be sent in on
a piece of glazed paper.
In regard to diphtheria there are some points to be noted. As nearly
all cases are diagnosed by culturing the organisms, the swabs should be
on wire or, if any other handle is used for the swab, it should be at least
four inches long so that the swab may be rubbed on the surface of the
medium in the test tube. Also when the specimen is submitted on a
swab which is not sterile there is danger of having it contaminated by
some organism which will cause an overgrowth and crowd out the
diphtheria bacilli so that they do not show up on the culture.
While I was preparing this paper a swab came in to be examined
for diphtheria which was on a piece of wire an inch long in a bottle,
which was sent out for hookworm and which contained carbolic acid.
What is the use of making a culture for this when we know that the
carbolic acid has killed all the bacteria on the swab?
(168)
The precaution of having a sterile swab or container for other
specimens in which the identity of the organism is to be determined by
cultural methods is also very much to be considered. For example, a
specimen is sent in from an abscess caused by streptococcus pyogenes.
A culture is made and we find staphlococcus bacillus subtilis and
bacillus coli or some other organism. The time and labor of examin-
ing the specimen are lost and the diagnosis and proper treatment are
delayed for two or three days unnecessarily and the physician and
laboratory are blamed by the patient.
Regarding tuberculosis examinations there has been considerable
discussion ; one bacteriologist going so far as to say that laboratory
examinations of sputum were more of a detriment than a benefit as
negative results are obtained from patients who have tuberculosis. This
is, perhaps, true, but this danger of getting negative findings on positive
specimens could be considerably lessened if all the specimens sent in
were fair specimens and contained a sufficient quantity of sputum. We
get a considerable number of specimens in which the only way to dis-
cover whether or not any sputum is mixed with the disinfectant already
in the bottle is to centrifuge the whole thing. The trouble is that when
a specimen bottle is left with a patient or handed to him, he expectorates
in the bottle without getting any of the purulent matter from the lungs
but submits a specimen of mucus and saliva which, of course, does not
confirm the physical findings in a case of tuberculosis.
Gonorrhoea. The greatest trouble in making a diagnosis of gonor-
rhoea is when a specimen is sent in from a female patient ; oftentimes
the swab or smear is taken from the vagina and the resulting picture
under the microscope is a mass of bacteria of seven or eight different
kinds and even if there are any diplococci the bacteriologist can not be
sure that they are gonococci. The best way to get a satisfactory
examination is to take two smears, one from the urethra and one from
the cervix uteri with the aid of a speculum. In other words get the
specimen from the seat of the infection.
Since there has come to be a standard 'bacterial content for drinking
water the number of specimens sent in for examination has markedly
increased and the physician is often asked concerning the advisability
of submitting a sample of well water for examination. As a rule Flor-
ida well water is exceptionally pure and if collected in the proper man-
ner shows a very low bacterial count. The laboratory is often called
upon to make examination of water where there is no necessity for it.
There should be some epidemiological reason for the examination of
the water before the user of the well is advised to submit a sample for
examination.
For a water examination to be of any value whatever it is neces-
sary that it be collected in a sterile bottle with a glass stopper and great
care should be taken that the water in the bottle does not come in con-
tact with the fingers of the person collecting the sample. If the sample
can not be brought to the laboratory immediately it should be packed
in ice as the bacteria will rapidly increase if kept at atmospheric tern-
(159)
perature. It is the general rule that samples brought in are brought in
ordinary medicine bottles or whisky bottles with cork stoppers not
sterilized. Then, of course, it is necessary to take the trouble to collect
the water all over again, whereas if the applicant had taken the trouble
to inform himself that a specially prepared container could be obtained
from the laboratory this time could be saved.
It is a fact that the laboratory often examines specimens of various
kinds for physicians when they should be thrown away and another
specimen requested because, although these specimens sometimes serve
to make a diagnosis, more often a half hour is wasted and the work
has to be repeated.
Another condition about which the physician is very often consulted
and on whose decision lives often hang is in connection with rabid dogs
and other animals. The first impulse of the public is to kill the dog
before he does harm or more harm, as the case may be. The proper
procedure in such cases is to confine the animal and watch his symptoms
and not kill him before he develops symptoms of rabies. If an animal
is mad he will generally die in three to five days, whereas if he is killed
the brain may not show negri bodies as these are not always to be found
in the early stages of the disease and if they are not found and the dog
has bitten someone, animal inoculation has to be resorted to. It takes
from two to six weeks to develop the disease in a rabbit, so the haste in
killing the dog causes loss of time in diagnosis of the condition. Also
it -often happens that a dog's head is sent in in which decomposition has
begun in the brain and this, by destroying the nerve cells, makes
diagnosis doubtful or very difficult to confirm, which emphasizes the
necessity of packing the liead in ice.
Urinalysis. Although urinalyses are no longer made in the laboratory
as routine work we sometimes have requests for analysis to detect
special conditions. In this connection the most important considera-
tion is a clean receptacle which should really be sterile. A sample may
be sent in and by the time it reaches the laboratory it has become full
of bacteria, and although these bacteria may have come from the
urinary tract there is no way of knowing this as they more often
multiply in the bottle. One physician took the precaution to use
formaldehyde as a preservative, when he requested an examination,
which would require cultures of the sample.
Regarding spirochetes, the essential point in the examination for
these is to make the smear of the serum without being mixed with blood
cells as these make the examination unsatisfactory.
Dysentery. It is very difficult to distinguish the amoeba of dysen-
tery unless they can be observed while moving or, in other words,
unless they are alive. Because of this no antiseptic should be added
when a portion of feces is to be examined for amoeba, and the earlier
the specimen reaches the laboratory the better. The ideal way to col-
lect a sample is by means of a rectal tube which will allow the mucus to
be collected without the feces and, if possible, this should reach the
laboratory while still warm.
(170)
With regard to specimens to be examined for bacillus of dysentery
and typhoid, as these can have no disinfectant in them special containers
which comply with the United States mail regulations should be sent for.
As it is unlawful to send specimens of feces for cholera through the
mails, under any circumstances, this should not be attempted but the
Board of Health applied to, when an official will be sent to the case
or the specimen can be personally conveyed to the laboratory.
The last point I will mention is with regard to pathological speci-
mens. To save time in the examination of these they should be sub-
mitted in about 70 per cent alcohol as this saves one stage in their pre-
paration for final sectioning, whereas if the specimen is sent in formalde-
hyde no time is saved.
SHOWING HOW HOUSE FLIES BREED.
With the idea of ultimately gaining the co-operation of the public
in ridding Key West of natural breeding places of the fly, and the
resultant elimination to a great extent of the flies themselves. Dr. J. Y,
Porter, Jr., assistant to the State Health Officer with headquarters in
Key West, is endeavoring to educate the people of that city along the
lines given in a recent report, which follows :
Relative to the fly exhibit maintained in the front of this office, I
have the honor to report as follows :
It occurred to me several weeks ago that a practical demonstration
showing how flies breed, what they breed in, etc., would be an excellent
thing to bring the fly question before the public, excite an interest in
the subject, and finally to gain their co-operation towards getting rid of
the fly's natural breeding places.
Accordingly, flyblown manure is collected and placed into suitable
glass jars, and placed on display in front of the office. On each side
are the fly posters of the State Board of Health, in English and Spanish.
There is also a short paper giving the life history of the fly.
It has been found necessary to place these jars on a bench with the
bench legs in cans of kerosene, otherwise the ants will attack and destroy
the fly larvae.
As a rule there are three jars on display, one having manure con-
taining a large number of maggots, one with the fly puparia, and the
third having adult flies. All jars are covered on top with mosquito
netting.
At first when a great deal of interest was manifested, it was my
custom to station the sanitary patrolman on the porch and have him
givft a short talk on flies. In this way, people who could not read or
would not take the trouble, got the essentials in an easy way.
In addition to the exhibit shown on the office porch, another one has
been maintained at the drug store of Mr. Thomas Otto, where I under-
stand it has attracted a great deal of attention.
A short time after the adult fly comes out it dies. An attempt was
made to keep them alive by feeding, but without success, thus showing
that the house fly does not do well in captivity. Therefore, it has been
necessary at all times to maintain more jars than are shown on the
porch, to replace the ones that go bad.
WHY BLAME PROVIDENCE?
How long will it be before the usual resolutions of condolence, which
now begin "Whereas, it has pleased our Heavenly Father to remove
from our midst our beloved Brother or Sister who sur-
rendered this life after a long illness from typhoid fever," shall be
changed to read, "Whereas, another case of criminal negligence has
occurred in this community, through the death of Mr. or Mrs. ,
resulting from the drinking of water from a polluted public supply. A
coroner's jury has affixed the blame on certain careless private parties
and some public officials, and recommends they be held for man-
slaughter. The county attorney has determined such shall not occur
again, and will push prosecution."
This is the headline in case of automobile accidents — why not in the
latter instance? It's a poor rule that fails to work both ways. Any-
how, why blame the Lord? He has enough charged to him by short-
sighted and unthinking mankind, — Bulletin of the Katisas State Board
of Health.
SOME THOUGHTS ON CHILD HYGIENE.
In dealing with the question of school children, and what is best
for them in the schoolroom, as well as their training at home, there is
a much mooted question that, as present day sanitarians, it seems we
should touch upon, at least. That is, the knowledge of the functions of
the different organs of the body with particular reference to those of
sex.
Rosenau, in his recent publication, "Preventive Medicine and
Hygiene," says: "Superficial information is not true education. On
the other hand it is a mistake to dwell unduly upon the subject * * *.
There is nothing truer than this statement, for unless the subject is
handled with the greatest delicacy, the childish mind is too likely to
become morbid, and the desired result is defeated.
Teach the children that the body is the sacred temple of the soul, and
therefore must be kept clean and sweet and wholesome, to keep the
soul, and mind and heart pure as God intended them to be kept. When
they ask questions, answer them truthfully, but explain that these arc
matters which they should not discuss too freely ; and teach them of the
beauty of life as exemplified in the lives of the birds, and flowers. Do
not force these issues on them, in mistaken zeal to follow the present
day teachings. The present day tendency is to go to the extreme in
these matters, and if it was a mistake in the past generation to keep
the children in ignorance of the great question of life, then, in this age,
the pendulum is swinging too far in the opposite direction, and the
education in this line is being overdone. Moderation is a blessed thing,
(172)
and this applies to matters of this kind, as well as to other human affairs.
It is a question if the modern method of handling this great subject
is not in a way, responsible for the shocking lack of modesty, yes, and
I will say, morality, of the present generation. One of the charms of
youth is modesty, and who can say the modern girl is overburdened
with this virtue when she will appear in the apparel that is the fashion
of the day, and seems to take a genuine pleasure in arousing comment?
Is it not true that there is too little reserve displayed? The children
should have self-knowledge, yes, but this knowledge should be imparted
by the parents, and the outside discussion dispensed with. As a nation
we are considered extremists, and this trait is shown up in the avidity
with which we grasp every opportunity to display our "up-to-dateness"
in all questions of the day.
Common sense is a blessing from the gods, and if common sense is
just given a chance to control this matter of sex education of the child-
ren, there is no danger of going too far and producing a race of morbid,
introspective and worldly wise children.
On the other hand, when common sense is given a chance there is
no danger that the child will be kept in ignorance of these vital facts to
the extent of endangering his future health and happiness.
Then, by all means, let the children receive this information, but
let it come from the parents, and be tempered with common sense, so
that the little minds will continue to have the normal, happy and health-
ful thoughts of childhood.- — L. B.
STATISTICS.
SMALLPOX.
Reported cases of smallpox in Florida, September, by counties (172
vaccine points distributed) :
Duval -- 4
Escambia - 3
Hillsboro 1
Total cases, September 8
Total cases to October 1 (1913) 1,0T7
RABIES.
Report of rabies in Florida, September, by counties:
No. persons treated.
Duval 3
St. Johns 1
Total number persons treated, September 4
Total number persons treated to October 1 (1913) 95
Deaths from hydrophobia, September 1
Total deaths from hydrophobia to October 1 (1913) 4
CLANDERS.
Report of outbreaks by counties, September, 1913 :
Duval '. 8
Total number cases to October 1 (1913) 50
(173)
hog cholera (Distribution of Serum)
Amount hog cholera serum distributed, September „ 41,730 c, c
Amount hog cholera serum reported administered by agents, Sept.. 17,810 c. c.
Number hogs reported treated, September 888
Total weight hogs treated, pounds , 83,850
TICK ERADICATION.
Counties visited by Tick Eradication Agents of the State Board of
Health , September: St, Johns, DeSoto, Hillsboro, Lake.
Counties in which clubs were formed during September : St. Johns.
Cattle dipping vats constructed during September (by counties) :
Putnam 1
Total number vats built to Octoner 1 - 32
SPECIMEN EXAMINATION, BACTERIOLOGICAL LABORATORIES.
Jacksonville. Tampa. Pensacola.
Animal parasites ,
Diphtheria
Gonorrhoea
Malaria
Pathological
Rabid dogs
Tuberculosis
Typhoid fever
Water (for sewage contamination)...
Miscellaneous
1Q1
421
40
359
4
7
35
159
10
51
167
143
44
464
81
104
H
10
53
324
31
33
29
SI
Total.
411
888
115
767
14
7
209
292
IS
158
1,237 1,032 610 2,879
Grand total number specimens examined by State Board of Health Labora-
tories, September, 2,879.
DISTRIBUTION OF DISEASES DIAGNOSED IN SEPTEMBER.
REPORT OF CENTRAL LABORATORY, JACKSONVILLE,
, MALARIA s Vndc-
Typkoid, Hoot.
Diph.
Jacksonville 8
Sarasota
Gainesville 13
Wclborn
Tallahassee 1
White Springs
DeFuniak Springs 4
Bradentown
Greenville 1
Sneads
Marianna 3
Waucfiula
Sanford 1
Havana
Lake Butler, 1
Okeechobee
Greensboro 1
Palatka
Wildwood 2
Hampton
Christiana 2
Worthington
St. Augustine 1
T. B.
15
1
1
1
1
1
1
1
1
13
1
3
1
1
Tertian.
6
Acstivo.
1
termined
5
Carried forward... 38
11
44
10
(174)
Brought forward.. 38 11
M icanopy
Palmetto 1
Altha
Apalachieola 1
Leesburg •
Orlando 4
DeLand
Dowling Park 1
Umatilla
Live Oak . . 1
Archer
Palm Beach 1
Bronson
Brookcr 1
Milliard 1
San Antonio ..,. 1
Myrtle 1
Starke 1
Green Cove Springs 1
Mayo 1
Titiisville 1
Miami
Alachua
Jefferson, Tcnn
Daytona
Fort Pierce
St. Petersburg
Emporia
Bushnell
New Smyrna
Tampa
Manatee
Bartow
Blichton
Crescent City
Arcadia
44
3
2
%
1
1
2
1
10
1
7
i
Total
40
36
78
30
Diphtheria
Tampa 19
Plant City 4
Sarasota 2
Oneco 1
Port Tampa 3
Youmans 1
Picnic 1
Lakeland
Brewster
Errit
Largo
Dover
Green Springs
West Tampa
Fort Myers
Palmetto —
REPORT OF TAMPA LABORATORY.
Hook-
Typhoid, worm.
7 11
21 3 13
Tuber-
culosis. Malaria.
23 21
1
37
17
30
22
(175)
Tuber-
culosis. Malaria.
7 6
REPORT OF PENSACOLA LABORATORY.
Hook-
Diphtheria. Typhoid, worm.
Pensacola 14 1 4
Marianna 1
DeFuniak Springs 12
Millville 1
Panama City , l
Freeport 1
Caryville 1
Bonifay 1
Hosford .. l
Sneads . . 3
Campbellton . . 2
33 1 12 8 6
Total cases of diseases diagnosed by Laboratories of the State Board of
Health during September :
Diphtheria. Typhoid.
Central Laboratory 40 26
Tampa Laboratory 37 9
Pensacola Laboratory 32 1
Total for State 109 3S
Hook-
worm.
78
17
12
107
Tuber-
culosis.
30
30
8
68
Malaria.
37
22
6
65
VITAL STATISTICS EXTENSION IN THE UNITED STATES.
The following abstract is taken from "Physicians' Pocket Reference"
of the Bureau of the Census :
Beginning with the seventh census (1850) an effort was made to
collect statistics of deaths through the enumerators of population as a
part of the general census. This method was unsuccessful in giving
reliable results — vital statistics can not be obtained by enumeration but
only by immediate registration — but the plan was pursued at each sub-
sequent census until the thirteenth (1910), when it was dispensed with
entirely.
In 1880 the results of registration of deaths under State and
municipal authority were utilized, thus establishing the registration
area. This consisted of only two States, Massachusetts and New Jer-
sey, the District of Columbia, and certain registration cities in non-
registration States. The aggregate population represented was 8,538,-
366, or 17.0 per cent, of the total population of continental United
States.
For 1900 there were added the States of Connecticut, Delaware (not
entitled to admission and dropped at the next census), New Hampshire,
New York, Rhode Island, and Vermont, which increased the percentage
to 31.4.
For the census year 1900 (ending May 31), there were added Maine
and Michigan, raising the percentage to 37.9.
The compilations theretofore, made were only for census years, there
being no data for the intercensal period. Beginning with the calendar
year 1900, and since the establishment of the Bureau of the Census up-
(176)
on a permanent basis, there have been regular annual reports (Mortality-
Statistics, 1900 to 1911) and large additions to the registration area due
to the constant efforts made by the bureau in co-operation with medical
and sanitary organizations and with State authorities.
Indiana was added for the calendar year 1900.
California, Colorado, Maryland, Pennsylvania and South Dakota
(dropped in 1910) were added for 1906; Washington and Wisconsin
were added for 1908 ; Ohio for 1909 ; Minnesota, Montana and Utah for
1910 ; and Kentucky and Missouri for 1911. The aggregate estimated
population for the last year was 59.275,977, or 63.1 per cent of the total
estimated population of continental United States. The vast number of
839,284 deaths was returned for the latter year, so that although the
United States does not possess a complete system of death registration,
it does possess returns of great value from the twenty-two registration
States, not including North Carolina from which returns are received
from all municipalities of 1,000 population and over under State law,
District of Columbia, and 38 registration cities in nonregistration States
now constituting the registration area.
The fundamental importance of accurate vital statistics for the
protection of human health and life is universally recognized, and
greater attention is being given to the subject throughout the country.
Especially is there widespread interest in the South, which has hereto-
fore been entirely unrepresented by reliable State registration — to its
large sanitary and financial loss, because vague rumors of high mortality
can only be confuted by accurate registration of deaths.
PUPPY DOG NO RELATION.
In the Island City of Key West there lives a three -year-old young-
ster, who is kin to the State Board of Health. He attends kindergarten,
but his grammar is woeful. The other day the new kindergarten teach-
er said to him, "J. Y., have you any little brothers or sisters?" His
answer was: "I ain't got nothing but a puppy dog and he ain't no
relation," and the reply broke up the conversation.
The Palatka Neti's, of October 10th, quoted the following :
"Who for the public has no better use
Than to smear clean walks with tobacco juice,
Expecting others to clean his muss,
Can be justly termed a 'dirty cuss'."
It is estimated that each man, woman and child in Florida pays 10
cents a year for the State Board of Health — we believe that the service
is worth a hundred dollars a year to every man, woman and child and
a thousand to every town. Therefore, the State Board of Health
furnishes the proof that when properly managed the cost of living may
be made ridiculously and even wickedly cheap. — Florida Times-Union.
^ORIp^
Health
Notes
STATE
OFFICIAL BULLETIN
Published Monthly by the
BOARD OF HEALTH
Subscription 50 cents per Annum
Entered as Second Cmss Matter, April 20, is 10,
At the Postoffice at St. Augustine, Florida, Under the Act of July 18, 1884.
Vol. VIII
November, 1913
No. 11 (££)
Hon. Frank J. Fearnside. President, Hon. S. R. Mallory Kennedy, M. D.,
Palatka, Fla, Pensacola, Fla.
Hon. C. G. Memminger,
lakeland, Fla.
EDITED BY
Joseph Y. Porter, M. D., Secretary and State Health Officer,
EXECUTIVE OFFICE AND CENTRAL LABORATORY I
State Board of Health Building,
Springfield Boulevard,
Jacksonville.
BRANCH LABORATORIES:
State Board of Health Building
Florida Avenue and Constant Street, Tampa.
City Hall, Pensacola.
Sent to any address in the State for the asking.
If you receive it without asking, it means that someone else has requested
it for you.
When you change your address drop us a card.
When giving change of address, give both the old and the new.
Anything you want to know about the public health we will try to tell you.
Any information you want about communicable diseases of domestic animali
we will help you to get.
Address communications to Jacksonville, Fla.
/ find the gayest castles in the air that were ever piled far better for comfort
und for use than the dungeons in the air thai arc daily dug and caverncd out by
grumbling, discontented people. A man should make life and nature happier to
us, or he had better never been born.— Ralph Waldo Emerson.
(178)
WOOLEN UNDERWEAR
The question is frequently asked, "Should a person in Florida use
woolen underwear ? Is it healthful and is it needed ?" The answer to
this query depends altogether upon three things — first, is woolen under-
wear uncomfortable; secondly, does it produce an irritation (which in-
quiry may be said to be embraced in the first question), and thirdly, does
the action of wool upon the skin cause a hyper -secretion of the skin
glands producing too great perspiration?
There can be no doubt but that certain individuals whose surface
circulation is sluggish get comfort from light texture of wool in summer
with a corresponding heavier weight and quality in winter. In this
class of persons there seems to be naturally a lowered action of the
sympathetic nervous system ; that organization of the body in its
anatomical division which supply controls the blood vessels— makes
them dilate and contract, and also regulates the functions of many
internal organs. Blushing, for an example, is but the action of the
sympathetic nervous system through emotion upon the blood vessels of
the cheeks. A deviation from normal health by chilling will, through
the influence of this system, so constrict the blood-vessels that the
temperature of the body is lowered to positive discomfort and has to be
raised by artificial means before the individual feels nonnal again. As
in cold water bathing: if the skin reacts quickly after a cold plunge, by
a warm glow which should appear, showing an active circulation of the
small blood vessels of the surface, then the cold bath does the partici-
pant good, is healthful, stimulating and invigorating; otherwise not ; and
so it is in the employment of flannels for underwear, both in summer
and winter. Their use is healthful and contributes to comfort so long
as the skin is not kept in a too active state of elimination by undue
warmth, but the minute that this does occur, then wool next to the skin
becomes discomforting and perhaps an injury, because an over activity
of the skin follicles takes place and renders the person susceptible to
chilling of the body if exposed to a change in outside temperature. "A
check of perspiration 1 '' as a cause of "taking cold" is an old saying which
has almost passed into an adage, and this chilling of the body driving
the blood from the surface to the interior organs, to congest and engorge
them, is responsible in a great many instances for the nasal and bron-
chial disturbances of both winter and summer, for we all have experi-
enced the seeming paradox of "summer colds."
Every one should be a law unto himself or herself as regards under-
wear. No two people experience the same degree of comfort or dis-
comfort in textures, either in quality or weight. Whatever is comfor-
table, whatever keeps one in a condition of sufficient warmth in winter
or coolness in summer, is the correct and healthy texture to wear
whether of wool, cotton, or linen mesh.
J
(179)
REPORT OF SENIOR BACTERIOLOGIST CONTAINING
SUGGESTIONS TO PHYSICIANS.
DIPHTHERIA.
The report for the month of October shows an unusually large num-
ber of specimens submitted for examination. The bulk of these exam-
inations has been of swabs taken from school children in the city of
Jacksonville. In all we have had twenty-five new cases of diphtheria
in the city and seventy-eight positives from release and carrier cases.
Out of a total of 1,737 cultures we found 148 positive ; of these posi-
tives 103 were for Jacksonville, leaving forty- five positive examina-
tions for sixteen other towns in the State, apparently indicating that
diphtheria outside of this city was of minor importance. This, how-
ever, is not true, because the City Board of Health ordinance here
requires that each case shall have two negative release cultures before
quarantine is raised. This gives us an increased number of positive
and negative examinations for this city which we do not get for other
cities in the State where there is no ordinance requiring two negative
cultures before releasing patients who have had diphtheria. In many
places it seems that they do not make any effort whatsoever to deter-
mine whether or not persons who have had diphtheria are free from
organisms at the time they are released. This is not a very satisfac-
tory condition because many such persons will be released from quar-
antine while they still harbor virulent organisms in their throats and
are the source of a spread of the contagion. I am not speaking of such
persons in the sense of ordinary carriers now, but of persons who have
actually had the disease. I believe it is proper to advise the physicians
generally throughout the State to make greater efforts to secure nega-
tive cultures before releasing their patients. Many submit a specimen
for diagnosis and when a positive report is obtained give antitoxin
which relieves the patient of the symptoms, but we know, from repeated
experience, that the antitoxin administration does not always destroy
the organisms in the throat and if such individuals are released from
quarantine as soon as the membrane has disappeared and as soon as
actual clinical symptoms have abated, they can still be a very prolific
source of infection for others. I would, therefore, suggest that the
Health Officer, through the medium of Health Notes, urge upon the
physicians to observe greater care in releasing diphtheria patients and
to submit more specimens from such patients for release. Those in'ho
have been in the habit of making their diagnosis simply on th-e clinicat
symptoms and the absence or presence of a membrane should begin
submitting specimens both for diagnosis and release, I do not mean
to say here that they should always wait for the report on the first
diagnosis culture before giving antitoxin because there are times when
the symptoms are so definite and the toxemia so great that antitoxin
should be given at the earliest possible moment. They can have the
satisfaction of a confirmation of this diagnosis from the laboratory and
reports can be wired if so desired. While most cases which show a
(180)
membrane are diphtheria we know that there are some cases which
simply have a pseudo membrane and are not diphtheria. Such clear
up either with or without antitoxin and the administration of antitoxin
under the circtim stances is both a financial loss to the patient and makes
it unsafe for such an individual to have antitoxin or other horse serum
therapy at a later date. These cases are not many, but they neverthe-
less occur and I mention them, and probably emphasize them, here
because in the past few years I have found that there are times when
such occurrences can be avoided if the physicians will only consult the
laboratory in the matter.
PATHOLOGICAL TISSUES.
I also wish to recommend that the doctors who use the laborato-
ries of the State Board of Health for making microscopical diagnosis
of tissues removed at operation observe a little more care in sending
such tissues for examination. We receive specimens frequently in any-
thing but the proper container and medium. Some send in crushed
pieces of tissue between two slides ; others send in a piece of dried up
tissue in a piece of paper or gauze, and very few specimens are accom-
panied by data which is of any importance from the laboratory stand-
point. If a physician wishes a microscopical diagnosis on a tumor he
should send in the entire piece of tissue or tumor removed at operation
when the pathologist may have the privilege of examining the entire
specimen and selecting the portion for microscopic examination which
promises to give the desired information ; for instance, a breast or a
uterus may harbor a malignant growth and yet if the specimen is not
properly selected the microscope will not show the malignant condi-
tion. Pathological tissues should be submitted in 70 per cent alcohol
and should be accompanied by full detailed information in regard to
the location of the tumor or diseased condition, whichever it may be,
and giving symptoms and duration of illness, stating specifically what
organ the said specimen is taken from or is a part of. We do not espe-
cially desire the physician's clinical diagnosis as that does not in any
way affect our own diagnosis. It is very important, however,
that we should have certain information in regard to these pathologi-
cal conditions in order that all the evidence may be properly weighed,
which, if done, very materially aids in arriving at a correct diagnosis in
the case. We also wish to urge that physicians who use the laboratory
for this purpose take the time to fill out the blanks which we send
them. We shall be obliged to take the position that if these specimens
are not of sufficient importance to the sender for him to fill out the
blank to the best of his ability they are not sufficiently important for
us to give our time in making diagnosis. We do not wish to be under-
stood as unwilling to make such examinations or doing our best to
obtain correct results.
RABIES.
The rabies situation among animals has been rather quiet until the
latter part of the month when we had a squirrel and a fox submitted
for examination. We found suggestive bodies in both of these ani-
(181)
mals, but neither one was sufficiently definite for a positive diagnosis
and we have accordingly made animal inoculations. We have had the
unpleasant experience, however, of having another man die with hydro-
phobia. This man was bitten some five or six weeks before the symp-
toms appeared. The dog was killed without sending the same to the
laboratory. The man, a patient of Dr. George Walter, of this city, was
seen by me on the first day of his active symptoms. The most pro-
nounced feature of the case was the throat symptoms, difficulty in
speech and some gastrointestinal disturbances. This is the third suc-
cessive case where men have been bitten, none of whom have taken
the Pasteur treatment, and all three have died with definite symptoms
of hydrophobia. I have examined the brains of two of these three
and found definite Negri bodies in both. It is remarkable that after
all the preaching and persuasion which has come from the State Board
of Health and others in this vicinity that individuals who are bitten by
dogs do not at least take the precaution to consult some of the health
officials in such matters. A more detailed report will be made of this
last case at a later date.
SPECIMEN EXAMINATION.
The other examinations for the month have been of the ordinary
routine nature and do not call for special comment. The total number
of specimens examined in the Central Laboratory is 2,688. The Tampa
Laboratory examined 832 specimens, and Pensacola reports 540, mak-
ing a total of 4,060 for the month of October. The accompanying list
of distribution of diseases as diagnosed shows that the Central Labora-
tory made positive diagnosis for fifty-six different points in the State
with a total of 302 of such diseased conditions of communicable nature.
This report does not include rabies or pathological specimens or other
of the miscellaneous unclassified.
RAT PROOFING OF MUNICIPAL SEWER SYSTEMS.
A report of the investigation to find a practical method of rat-proof-
ing the sewer system of San Francisco, by Dr. Frtench Simpson,
Passed Assistant Surgeon, United States Public Health Service, out-
lines certain modifications to catch basins as an effective method of
eliminating and controlling rats in sewers.
Complete report by Dr. Simpson containing cost and specifications
for the reconstruction of old-type basins, and specifications and original
cost of the modern type catch basin, may be had by applying to Surgeon-
General, Public Health Service, Washington. D. C. This report
appeared in October 31 issue of Public Health Reports,
Dr. Simpson points out that the city sewer may be considered a
permanent harboring place for rats, providing, in addition, a conven-
£182)
tent and extensive highway for their rapid travel from one point of the
city to another ; that, to a considerable extent, rats enter and follow this
highway in their migrations from house to house; and that the rat-
proofing of city sewers would not only reduce danger of spread of dis-
ease by rats, but would reduce the number of rats infesting such
premises and prove an important element for their general control
and final elimination.
"MOVIES" WILL SHOW FAKE CONSUMPTION CURE EVIL.
How thousands of consumptives lose their lives annually by taking
fake cures for tuberculosis, will be depicted in a motion picture film
which has just been produced by Thomas A, Edison, in co-operation
with the National Association for the Study and Prevention of Tuber-
culosis. The 61m is entitled "The Price of Human Lives," and will be
placed on exhibition in theatres throughout the United States on
December 2. It has been designed to further the Red Cross Christmas
Seal sale and the general and- tuberculosis campaign.
The story of the picture centers about the wealthy proprietor of a
drug concern named Gregory Cort and his daughter Beth. In the
earlier scenes of the play a striking contrast between the lavishly fur-
nished Cort home and the dingy tenement room of Nellie Linn is
given. While Cort and his family live in luxury and happiness, his
principal source of income is derived from the sale of a fake consump-
tion cure called "Concura." Neither his daughter nor any of his inti-
mate friends know the exact nature of his business.
Nellie Linn is shown taking "Concura," to cure herself of a "hard
cold," while her lover, Ed Grant, goes to a fake consumption cure
doctor in answer to a newspaper advertisement. Beth is engaged to a
young man by the name of Harry Bruce, whom Cort finally induces to
become his advertising manager by showing him the huge profits which
he makes in his business. Meanwhile Beth, as a result of her interest
in Red Cross Christmas Seals, has enlisted as a social service worker
and in this capacity becomes acquainted with Nellie and Ed. She
becomes a friend of the family and attempts to urge them to stop tak-
ing fake cures for consumption including "Concura," Neither of them
pay much heed to her advice until one day Nellie receives a letter tell-
ing her that a near relative had just died from tuberculosis, simply
because she had delayed proper treatment too long by relying on "Con-
cura." Nellie shows the letter to Beth who declares that it is a crime
to allow the manufacture and sale of such false remedies. Burning
with indignation, and with the wrapper of the "Concura" bottle in her
hand she goes to the office of the company, where she finds to her sur-
prise and sorrow that the business is conducted by her own father and
that her affianced husband is the chief promoter of the swindle. She
refuses to recognize her lover after this discovery and forgives her
father only after he has promised to make full restitution as far as he
can to the suffering consumptives whom he has robbed. As part of his
(183)
reformation he sends Nellie and Ed to a sanatorium, where they may
be cured.
The closing scenes of the story show Gregory Cort as a changed
man. Bruce is also seen in a new role, namely, as the friend of the
Linn family and also as the manager of the Red Cross Seal campaign.
The story closes on Christmas eve of 1913, with the lovers restored to
each other, and Ed and Nellie making good progress on the road to
recovery.
The National Association for the Study and Prevention of Tuber-
culosis, 105 East 22d Street, New York, will send, free of charge to
anyone, literature on fake consumption "cures" and will be glad to give
as much information as possible with reference to particular alleged
"cures" for this disease. — Press Service of the National Association
for the Study and Prevention of Tuberculosis.
COLDS.
Now look out for colds!
This advice, as a paraphrase of the old time almanac editor's warn-
ings, is particularly timely at this season, although no one knows why
the name was given to that condition of sneezing, wheezing and gen-
eral miserableness that we wrongly associate with the cooler seasons
of the year. It is a fact that colds are more prevalent in the colder
months, but it is due only indirectly to lower temperatures, because at
these seasons we close the doors and windows, shut out more than in
summer the free circulation of fresh air, and breathe too much an
atmosphere which is vitiated by being depleted of oxygen.
Most of us cherish the idea that a sudden draft of chilling air is
the cause of a cold. More than likely this is but a coincidence. The
doctors have concluded that this affliction is infectious, that it may be
carried from one person to another by a germ, and it is often noted
that when one member of the family has a cold, the others are quite
likely to "catch" it. That all do not suffer together is due to the fact
that some individuals have a power of resistance that makes them
immune, at least for the time.
This power of resistance is a wonderful fact in the make-up of
human physical economy. To understand what the doctors mean when
they talk about it, we must consider the human body as a battle field,
whereon from birth until death a continuous fight is being waged be-
tween the leucocytes, the police scavengers in the blood, and the germs
of all diseases that human flesh is heir to.
These minute protectors of health are the little white cells in the
blood. They are described by the microscopists, who have an intimate
acquaintance with them, by names too long and difficult for popular
use by laymen, but there are several distinct classes of them, each with
its special field of usefulness. When danger threatens through the
invasion of disease germs, or by external injury which requires the
repair of bone or tissue, these little fighters rush to the rescue, they
(184)
multiply in numbers and activity, and if they are not overpowered they
win the victor)-, which means that health and normal physical condi-
tions are restored.
Their activity is the measure of this power of resistance, which
enables us to ward off disease and to escape infection when it threatens.
It is natural that it should be strongest in the adult in the full strength
of life, and weakest in the very young and in old age. This is proven
by the fact that by far the largest proportion of deaths occur in the
two extremes of life, and the smallest in the decades between twenty
and fifty.
It is well known that oxygen is a purifying agent, invigorating and
strengthening because of its cleansing power. The oxygen from the
air breathed into the lungs is carried into the blood where it reaches
these leucocytes and strengthens them for their important work.
Naturally, also, a lack of oxygen, exhausted from the air by breathing
or other means, induces a lack of resisting power. This means that a
plentiful supply of fresh, oxygen-laden air brought into the home by
perfect ventilation, is the best health preservative known to medical or
sanitary science, and it is one of the best cures, too. It is the best pre-
ventive of colds that can be found, and it has the advantage of being
decidedly cheap.
The germs that cause colds may be carried from one person to
another through personal contact or close proximity. They are expelled
from the patient by sneezing, violent coughing, in the sputum and in
the mucous discharges from the nostrils. To escape catching cold from
another person these germs must not be permitted to enter the system,
which may be made possible through a too close proximity with the
afflicted one.
Colds are more inconvenient and annoying than dangerous. Their
greatest danger, however, is in the fact that they predispose the patient
to the more serious diseases of the respiratory system, such as catarrh,
influenza, diphtheria, bronchitis, pneumonia and some forms of tuber-
culosis. They are not the cause of these diseases, but neglected they
prepare the system for more serious dangers.
Therefore, a cold should not be neglected. The inflammation of
the infected membranes should be reduced and the irritation caused
by such inflammation should be quieted and normal conditions restored
as promptly as possible.
All of us pity our cold-afflicted friends. Most of us have a never
failing remedy to recommend and we insist upon its efficacy with some
long story about how it has accomplished wonderful cures in cases we
have known. And most of us with colds listen to these stories (most
interesting to the narrator) with the wish that they had stopped before
they were begun. But, let it be remembered that the best cure for a
cold is the cheapest of all — deep and frequent inhalations of fresh,
oxygen-laden air. — Press Sen-ice State Board of Health.
(185)
NURSES FOR THE PUBLIC HEALTH.
Many Scranton people who have been deeply interested in the splen-
did work accomplished by our District Nurse Association may not
know that there is a national organization for public health nursing
which recently held a convention in Atlantic City with 1,000 trained
nurses in attendance.
Miss Lillian D. Wakl, the president, gave a notable address in
which she said : "During the last decade there has been wide propa-
ganda upon public health measures. Perhaps at no time before in the
history of the world have there been so many campaigns for instruc-
tion concerning health and hygiene and the prevention of illness. To
the trained nurse has properly fallen the responsibility of making prac-
tical application in the homes of the people of the results of scientific
thought and research. So long as nearly 90 per cent of the sick must
be cared for, by necessity or choice, in their own homes, just so long
will the efforts of the health nurse be required to give this care."
The purpose of our District Nurse Association is not fully appre-
ciated. Probably everyone understands its purely philanthropic side.
There are constantly cases of illness among the very poor to which
service must be rendered without charge. None suffer quite so much
as those whose illness is aggravated by an absence of the common
necessities. It frequently happens that the nurses find homes that are
fireless and foodless and the children neglected because of the prostra-
tion of the mother. Everything is unsanitary, sometimes positively
foul. In such instances it is not simply the duty of the nurse to bring
comfort and help to the sufferer, but also to organize a campaign of
preventive hygiene under the roof. She must keep the disease from
spreading, safeguard the innocent and instruct the ignorant ; besides
giving palliatives and correctives she is expected to be an apostle of
health, preaching a gospel of cleanliness, sanity and helpfulness wher-
ever she goes.
But the national organization of Public Health Nursing and our
local District Nurse Association both realize that there is another field
to which attention should be called. The possibilities of the movement
are not confined to charitable cases. Although such work must be
done when the need occurs, it should not be extended beyond the line
of absolute necessity. There are numberless cases of illness where the
family do not wish charity but are unable to employ a trained nurse for
an indefinite period at the regular rate of wages. They are able to pay
something, perhaps their share of a nurse's time for an occasional
visit. But, however small the sum, if it is only sufficient to pay the
nurse's car fare, it should be paid by the patient or by the patient's
friends. In this way the recipients of such service can preserve them-
selves from any reproach of being the objects of philanthropy.
We may point out in this connection that many employers, fraternal
organizations, insurance companies and municipal authorities are
entering into business arrangements with the nursing societies of vp«i-
(186)
otis places to look after the cases in which they are respectively inter-
ested. This can be carried still further to the benefit of all concerned.
The Scranton school district did all of its work of follow-up and
advice in connection with the medical inspection of scholars through
the local District Nurse Association, and will continue the policy this
year, Scranton is to be congratulated upon being in the forefront of
American cities in possessing a very efficient organization to aid in
preserving the public health,— Scranton (Pa.) Tribune-Republican.
ALWAYS GROWING OLD.
Dr. Woods Hutchinson, in his book ''Common Diseases," enter-
tainingly discusses old age conditions that will come to each of us if
we live long enough,
"If we are going to do anything to cure the disease of old age, we
must begin before birth. Indeed, as Oliver Wendell Holmes wittily
remarked in the prevention of disease, 'we must begin with the grand-
parents,' The so-called senile changes are changes which have been
going on ever since we began our individual existence.
"The time when we begin to feel old, the particular period at
which we begin to 'show our age,' is merely that period at which these
internal changes have reached and shown themselves upon the surface ;
in which, so to speak, these microscopic alterations have finally become
visible to the naked eye.
"It is nothing short of absurd to say that a man becomes old, or
senile, or inc?,jable of further development or incapable of the concep-
tion of new ideas at, or after, any special or particular age. There is
no one period of life in which we grow, and another in which we
decline. Both processes are going on side by side in every part of our
body from the day we are born. Just as the life of the body means
the death of certain of its cells, so the growth of every power and
faculty means the sacrifice and the decay of others. Every primitive
cell of the embryo lays down part of its life to become a muscle cell,
a neurone, a blood corpuscle, or a bone cell.
"The process has no limit, any more than it has beginnings. Life
is just that, one-third dying that two-thirds may live, whether it be the
single cell, or the hugest and most elaborate body. While in sucli
gross matters as mere avoirdupois and stature, and the actual horse-
power of our muscles, we reach a limit, a period of what we are pleased
to call maturity, at a comparatively early age ; yet, in other and more
important respects we continue to grow and develop steadily, to a very
much later period, fifty-five, sixty and even seventy years. New and
valuable achievements, masterpieces in every realm of human activity
and interest, have been produced hundreds of times in every decade,
up to and including the ninth,
"It is obvious then that there is no hard and fast 'dead line' which
can possibly be drawn, beyond which no further growth, or fresh crea-
187
tive effort, or new enterprise, or improvement is possible. In fact, by
living o healthful, active, happy life, and keeping up all our interests,
we can prow and develop and adjust ourselves, and fed that we are
growing until we are one day suddenly dead, without ever realizing in
any distressing or painful way that we are growing old at all." —
Exchange,
FOR MAKING SURFACE CLOSETS FLY PROOF.
The Notes calls the attention of its readers ti> a very mi it pie and
simple device, constructed by Mr. I). C. Covert, of Jacksonville, for
the fly-proofing of surface closets. This consists of a metal backboard
las shown) to slide up and be held open by an automatic spring-catch
in cleaning out die closet, and is a substitute for the wire screen which
is SO apt to be torn.
This can be installed at a small cost, and it is believed will fulfill
the purpose intended. Any particulars desired in regard to its c< instruc-
tion and installation may be had of Mr. Coven. It ia ii"t the idea of
the Notes to advertise this device, but the inventor has shown such
skill attd practical knowledge of the subject that it well merits investi-
gation.
(188)
STATISTICS.
SMALLPOX.
Reported cases of smallpox in Florida, October, by counties (636
vaccine points distributed) :
Alachua 13
Bradford 9
Brevard 1
Duval 15
Escambia 1
Hillsborough 3
Pinellas 3
Polk 8
Suwanee 1
Total cases, October 54
Deaths, October (Duval Co.) 1
Total cases to November 1 (1913) 1,131
RABIES.
Report of rabies in Florida, October, by counties :
So. persons treated.
Bradford *2
Walton ; 1
Total number persons treated, October 3
Total number persons treated to November 1 (1913).. 85
Deaths from hydrophobia, October 1
Deaths from hydrophobia to November 1 (1913) ... 5
*One treatment cancelled.
CLAKDERS.
Report of outbreaks by counties, October, 1913:
Duval 7
Osceola 1
Total number cases 8
Total number cases to November 1 ( 1913) 58
hoc cholera (Distribution of Serum).
Amount hog cholera serum distributed, October 93,750 c c.
Amount hog cholera scrum reported administered by agents, October. 30,765 c c.
Number hogs reported treated, October 1,22-t
Total weight hogs treated, pounds 96,850
TICK ERADICATION.
Counties visited by Tick Eradication Agents of the State Board of
Health, October: St. Johns, Putnam.
Places at which public demonstrations of dipping cattle were held
in October: Hollister (Putnam County).
Cattle dipping vats constructed during October (by counties) :
Baker, at Winn
Lake, at Leesburg
Seminole, at Sanford
Holmes, at Bonifay
Escambia, at Muskogee
Osceola, at Southport
Total vats built, October, 8
Total number vates built to November 1 28
(189)
SPECIMEN EXAMINATION, BACTERIOLOGICAL LABORATORIES.
Jacksonville. Tampa. Pcnsacola. Total.
Animal parasites 1S7 224 27 438
Diphtheria 1,890 119 232 Sy»J
Gonorrhoea 38 32 23 93
Malaria 225 245 41 511
Pathological 15 7 4 26
Rabies *4 ... ... 4
Tuberculosis 133 84 28 245
Typhoid fever 160 31 25 276
Water (for sewage contamination) 7 2 2 11
Miscellaneous 29 28 10S 165
2,688 832 540 4,060
Grand total number specimens examined by State Board of Health Labora-
tories, October " 4,060
♦One squirrel, 1 human, 1 cat, 1 fox.
DISTRIBUTION OF DISEASES DIAGNOSED IN OCTOBER
REPORT OF CENTRAL LABORATORY, JACKSONVILLE.
, MALARIA i
Town.
Archer
Apalachicola 5
Bradentown 3
Bronson , , . .
Bassinger
Brooksville
Bartow
Center Hill
Cocoa
Daytona . .
Delray 3
DeFuniak Springs — 2
Dowling Park
Fellsmere
Femandina 1
Floral City
Fort Myers
Fort Meade
Fort Pierce
Gainesville 3
Hawthorn
Jacksonville (new).,. 25
Rl, and Carriers 7B
Leesburg
Lloyd
Loughman
Mayo
Marianna . . . . L 9
a §
si
- £
= ? i
a .it
o
a
Carried f onward... 128
J2
13
13
1
1
2
18
1
1
30
.§ -•
2
5
3
1
1
1
S
e
9
3
1
1
2
1
1
3
2
4
2
1
1
2
2
7
1
93
73
1
1
1
1
9
35 238
1
1
14
(190)
MALARIA
Tou-n.
128
Brought foni'ard
Mandarin
Mcintosh
Miami
Micanopy
Morristown
Newberry
New Smyrna
Ocala 1
Okeechobee
Orlando
Oxford
Orange Park
Palmetto 1
Palatka 1
Plant City
Sanford 3
San Antonio
St. Augustine 1
St Petersburg
Sarasota
Starke ■
Tallahassee
Wauchula
Welborn
West Palm Beach
Lake Butler 1
Williston 1
Madison 1
c
a
c
a
13
i
c '~ \.
o
1
6
S
13
K
5
-a
30
35
1
4
Total.
.148
15
I
REPORT OF TAMPA
Tampa 13 12 1
Nocar.ee 1
Sarasota 1
West Tampa 1
Youmans 1
Release Cultures 27
Clearwater -■.-.■
Bradcntown
Arcadia
Floral City
Lakeland
Wauchula
Plant City
Fort Myers
St. Petersburg
Punta Gordo
Gardenville
Chicora
Kissimmee
Palmetto
LABORATORY.
11 13
ID
11
38
14
19
Total.
44 14
1
11 10
14
23tf
2
3
5
6
1
1
1
2
1
3
1
2
1
1
1
17
1
2
1
3
64 302
04
1
1
2
1
27
2
i
i
2
2
1
1
•
3
1
■ 1
1
1
1
146
(191)
REPORT OF PENSACOLA LABORATORY
, MALARIA .
•S
£Z
w
•ft
cs
Pcnsacola 2
DeFuniak Springs.:. 5
Apalachicola
Bonifay 1
Marianna 10
13
8
| ,1
I IS
,° § a
?•§
a
1
c
s
2
2
IS
7
1
1
10
37
Total cases of principal diseases diagnosed by Laboratories of the State
Board of Health during October:
Conor
rkoca.
15
14
3
Diph-
theria.
Central Laboratory 148
Tampa Laboratory 44
Pensacola Laboratory. . . IS
Tuber- Hoek~
Malaria. Typhoid, culosis. worm.
18 ID 38 64
31 14 21 22
5 1 G 4
Total for State.
♦210
32
f.4
34
63
90
♦Includes 105 releases and carriers.
"Vital statistics are to the health officer just what symptoms of dis-
ease are to a physician. Through the presence of symptoms the physi-
cian recognizes disease and studies the effect of his treatment ; through
vital statistics the health officer recognizes the sick social organism, the
sick town, county, or State, and estimates the effect of health adminis-
trations by the reduction of death rates.
"The vital phenomena of the social organism, of the public, are its
vital statistics. The vital statistics of a community, town, county, or
State are the only known means of reaching intelligent conclusions
regarding the health thereof." — Bulletin of the North Carolina State
Board of Health.
'"Finally, the proper recording of births and deaths is a matter of
the utmost importance to the cause of public health. Modern pre-
ventive medicine deals with the mass of mankind. It cannot, under
State direction, touch the individual except in the case of certain rare
diseases; it reaches him only through the community. The results of
public health work, therefore, and its success, depend on accurate infor-
mation as to the health of the community. But this, in turn, cannot be
had without an accurate report of every case of preventable disease, of
every birth, of every death. Vital statistics balance the books of life
and death ; without them, public health work can never audit accounts
for better or for worse."— Virginia Health Bulletin.
(102)
VITAL STATISTICS— REMINDER
This is to remind even' city official, doctor and citizen in the
few remaining cities of Florida (of 2,000 population and over)
which have not yet appointed registrars and provided by ordi-
nance for the reporting of births and deaths, to co-operate and
take immediate steps to have their city placed in the Registration
Area,
The many cities which have made provision for vital statistics
are to be highly commended : it is urged, however, that they con-
tinue to work for perfect statistics, and this applies fundamentally
to each citizen in individually supporting, and not holding back,
mortality reports in his town.
♦♦♦»♦♦♦♦♦♦♦♦♦♦»♦♦♦♦♦♦♦♦»»♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦
*V0R*D 4
HealthufBNotes
OFFICIAL BULLETIN
Published Monthly by the
STATE BOARD OF HEALTH
Subscription 50 cents per Annum
Entered as Second Class Matter, April 20, 1'JIO,
At the PosTOFFtcfi at St. Augustine, Florida, Under the Act of July 10, 1894.
Vol. VIII December, 1913 No. 12 (£%.)
Hon. Frank J. Fearnside, President, Hon. S. R. Mau.orv Kennedy, M. D.,
Palatka, Fia. Pcnsacola, Fla.
Hon. C. G. Memmincer,
Lakeland, Fla
EDITED I1Y
Joseph Y. Porter, M. D., Secretary and State Health Officer.
EXECUTIVE OFFICE AND CENTRAL LABORATORY :
State Board of Health Building,
Springfield Boulevard,
Jacksonville.
BRANCH LABORATORIES :
State Board of Health Building.
Florida Avenue and Constant Street, Tampa.
City Hall, Pensacola,
Sent to any address in the State for the asking.
If you receive it without asking, it means that someone else has requested
it for you.
When you change your address drop us a card.
When giving change of address, give both the old and the new.
Anything you want to know about the public health we will try to tell you.
Any information you want about communicable diseases of domestic animals
we will help you to get.
Address communications to Jacksonville, Fla.
Through seal knowledge is gotten, through lack of seal knowledge is lost:
let a man who knows this double f>ath of gain and loss thus place himself that
knowledge may grow. — Buddha.
(194)
NATURE'S DAILY DEMANDS.
That we are "fearfully and wonderfully made" is a fact self-evi-
dent to every human creature of whatsoever degree of intelligence, if
only a moment's thought is given to the subject. The "sweet signer
of Israel" calls attention to the truth that human life is a vast piece of
machinery' which Nature — another word for God — has so fashioned
and adjusted to the varying needs of man's physical existence, that
each particular function of this great human machine may fit in har-
moniously with the whole scheme for living. This human "plant" up
to a certain number of years, is a perpetual motion agent dependent
on supernatural means, unless interrupted abruptly by accident or dis-
ease. It is true, that like large "plants" which comprise many and
variously constructed devices of machinery, the human machine must
have careful attention else the journals will become "too hot" or the
"exhaust and discharge pipes" become clogged, and then will interrupt
and perhaps permanently disable the other working parts of the inter-
nal machinery. The human machine differs in no particular in respect
to needed care from that constructed of iron and steel. Both must
have attention or both will stop running in a very short while. The
"plant" which operates through the aid of steam or electricity is
equipped with pumps, valves, exhausts, condensers and discharge
pipes. The human machine is likewise provided with a complicated
pump, the heart; with vacuum chambers and air circulation. It has
a condensing apparatus through the lymphatic system by which the
solids when liquified in the great boiler, the stomach, are passed into
the digestive canal, absorbed and returned through the circulation
pipes, the veins, to the lungs, the large evaporators, in order to have
the injurious portions removed before being "turned into" nerve and
brawn. The machine devised by Nature differs from the machine con-
structed by man in that this human machine has several condensers
and evaporators especially designed for eliminating worn-out mate-
rial of different kinds from the nutritive elements which in the com-
plex system of assimilation are required to maintain life.
We know that it is the custom for engineers who look well after
the preservation of the boilers in a "plant" to see that they are regu-
larly "blown out." They do this, because of the accumulation of dirt
and rust in the boiler tubes; by cleaning out these tubes, the life of
the boiler is lengthened and preserved. Therefore, it is highly essen-
tial in conserving human health that the exhaust and discharge con-
duits be kept freehand open, so that that which is no longer needed in
the economy of living may not remain to pass into the circulation and
(195)
poison the general system. The care of the human machine requires
precisely the same thought and the same attention as the mechanical
device, so that it, too, may last longer and be efficient. Now, we are
getting at the gist of this article.
Purposely a comparison in working has been made of the human
machine — the physical man— to a machine constructed by man, of iron
and steel, to bring home more forcibly and more directly to personal
consideration, the necessity of maintaining a daily routine of "habits'*
if perfect health is desired.
At the risk of offending the hypersensitiveness of some, it is pro-
posed to speak plainly and to say that by "daily habits" is meant that
mindfulness of the human machine, which demands that certain func-
tions shall by daily routine methods be kept active and that not even a
day be allowed to pass without performing a duty which is demanded
of it or them. Do you know what happens if the air or vacuum pump
connected with a boiler becomes choked ? The steam is used up, and
if water is let in suddenly, then what? An explosion. And precisely
does this happen with the human when the exhaust and discharge pipes
fail to perform their necessary part in "blowing out" refuse material
and expelling impurities from the main channels of the human sys-
tem. A methodical and careful attention to these things will avoid and
prevent disasters to the human machine a* well as to the steel.
This advice is thought to be more needful to women than to men,
because statistics of certain ailments go to show that women, as a rule,
are more neglectful, and suffer more from the sequences of disregard
of daily habits, than do men. It is a very easy matter to form dailv
habits of nature's requirements, and when formed the habits "stick,"
and are almost automatically performed without much heed being given
to the necessity. Before infants can walk, indeed as soon as they can
sit up, intelligent and observing mothers will so direct the care of the
child that habits required by Nature will form then, and ever after-
wards be religiously carried out. Religiously? Yes, because it is a
part of religion to keep clean, and no one can be wholly clean whose
system is obstructed by cast off particles from digestive processes,
and which serve to do and act as poisonous elements when re-absorbed.
Just give this subject a little thought. May be you, who read it,
have already done so, but another "think" will do no harm, if consid-
ered in connection with the comparison which has been made to the
care necessary to preserve machinery constructed by man's intelligence.
(19d)
IMHOFF TANKS.
By Alex. H. Twombly, Civil Encineer.
The disposal of sewage presents two problems — the disposal of
liquids and the disposal of solids. The average sewage contains more
than 99,9 per cent water, and less than Mo of one per cent solid matter.
The Imhoff Tank accomplishes two important things. It separates
the liquids from the solids and it reduces the solids to a form in which
they can be handled safely.
The Imhoff Tank is divided into two compartments, "Typical Sec-
tion," an upper compartment through which the fresh sewage flows
slowly so that the solid matter contained in it which is capable of being
settled falls by gravity to the bottom of the upper compartment, and
thence by the outlets in its hopper bottom into the lower compartment.
The fresh sewage passes through the upper compartment in from one
hour and a half to two hours, which time is so short that no septic
action takes place and the effluent running away from the Tank has
not fermented.
In a settling tank without two compartments, the fermentation of
the solid matter which is settled to the bottom soon causes gases to
arise, which, passing through the sewage prevent complete settling of
the solid matter. In the Imhoff Tank the solid matter settles to the
lower compartment and the gases arising from fermentation pass out-
side of the upper compartment to the atmosphere, thus causing no
interference with the settling action in the upper compartment. Re-
sults prove that instead of settling the usual 50 to fi.5 per cent of such
solid matter as can be settled, that in the Imhoff Tank the settling
reaches 96 to 98 per cent.
The gases which come away from an Imhoff Tank are mainly car-
bonic acid gas and marsh gas, both of which are odorless. In con-
trast to this the gases which come off from single shallow tanks, are
apt to contain large quantities of hydrogen sulphide, which is very
offensive.
The Imhoff Tank is so constructed that the solids which have been
removed from the sewage remain in the lower compartment for three
months or longer, at the end of which time the destruction of non-
resistant organic matter and germs has been accomplished to such a
degree that an odorless sludge can be discharged through the outlet
pipe directly from the tank without further purification. At the end
of about three months a part of the sludge is removed from the bot-
tom of the tank at frequent intervals, so that the operation of the tank
becomes practically continuous, new sludge forming on top of the
older sludge and gradually taking the place of the older sludge at the
bottom as it is removed.
The disposal of sludge has been the most difficult problem with
which to contend, as the sludge usually has a strong odor and is very
slimy, causing a nuisance.
The methods of disposing of sludge in general use have been to
carry it to sea in barges where possible, to transport it in tram cars
(197)
to uninhabited sections and to dump it, after first removing as much
water as is possible by sand filtration on drying beds or by filter presses.
These methods are more or less productive of odors and nuisance.
SINGLE "TANKS WITH HORIZONTAL FLOW
— t Sewage Setting Tank.
(I—* *- < i***, Urn/
This form of horizontal flow tank is suitable for installation where
one or more single tanks are required. Its simplicity of construction
and operation often makes it more desirable than the single tank of
the radial flow type.
Sewage SefHing Tank.
£OOJh/ut0mnto
30.000 «faA MUy
Cipanh/ of seWing basin SOOcb.ft.
flomngjhreugh-tim* Zhours
C*ptcify ofstudge-frcompetTing ctomtw SOOi&ft}
For a small tank, where stresses due to water and earth are not
large, a plant of this rectangular form may be found simpler to build.
(198)
Sludg* Drying Beds
I*
I0QO00 ft»ph.
The sludge drying beds are divided into sections by wooden parti-
tions in order to aid in the proper distribution of the sludge and allow
the whole of the hed to be used to better effect. After lying on the
beds from three days to a week the sludge can be removed. A conve-
nient method for this removal is to shovel the sludge into small dump
cars running on rails. The rails in the separate sections are con-
nected by means of turn-tables to the main track leading to the sludge
dump. Some little of the fine surface sand on the beds is lost during
the sludge removal and this should be replaced when necessary.
The sludge from the Imhoff Tank when drawn through the sludge
outlet has only a faint odor similar to tar, which disappears in a short
time, leaving the sludge with an odor similar to garden soil. The
sludge is run directly onto drying beds consisting of about 12 inches
of gravel, under-drained, where the sludge rapidly dries. Ordinarily
the sludge from other systems requires from six to seven months to
dry, but the sludge from the Imhoff Tank on account of the absence of
slime and its peculiar consistency dries in from three to ten days, when
it can be shoveled into carts or tram cars and dumped upon any waste
or fill land without annoyance from odors or danger from fermenta-
tion. The amount of sludge is only about one-fifth of that ordinarily
obtained, as its destruction has been more complete, and the amount
of water contained in the sludge averages about To per cent against an
ordinary average of 95 per cent in other sludges.
The effluent from the upper compartment can be run directly to
sea. or where it is necessary to give it further treatment can be passed
over a trickling filter which consists of a bed of stone about six feet
deep, under-drained, upon which the effluent is distributed by sprin-
(199)
kler heads. This process thoroughly aerates the effluent. In its prog-
ress through the stone bed the bacterial action on the surface of the
stones assists in rendering the final effluent non-put rescible and stable.
The Imhoff Tank thus accomplishes the separation of the liquids
and the solids and reduces the solids to a sludge which is handled with-
out danger or without nuisance from odors.
The liquid effluent from which the solids have been separated is
then treated by well established methods, such as the trickling filter
or the contact filter, so that it is rendered non-putrescible and stable.
This treatment, however, is unnecessary where a sufficient volume ot
water is moving to oxidize the effluent as it comes from the Imhoff
Tank.
Twombly & Henney, Engineers, New York.
ANAPHYLAXIS.
Dr. Hanson, Senior Bacteriologist of the State Board of Health,
explains the term "anaphylaxis" in connection with serum therapy.
(Extract from his monthly report, November, 1913, to the State Health
Officer) ;
"On account of some inquiries which have been made on the fol-
lowing statement — ,
While most cases which show a membrane are diphtheria
we know that there are some cases which simply have a pseu-
dic membrane and are not diphtheria. Such clear up either
with or without antitoxin and the administration of antitoxin
under the circumstances is both a financial loss to the patient i
and makes it unsafe for such an individual to have antitoxin
or other horse serum therapy at a later date.
I wish to add a word of explanation in regard to this matter. It has
been found by very good investigators, such as John F. Anderson,
director of the Hygienic Laboratory ; Hektoen, of the University of
Chicago, and many others who have studied the subject of anaphy-
laxis, that laboratory animals as well as humans may become sensi-
tized by the administration of foreign serum or p rote id. An animal
which has been injected with some foreign serum, like horse serum,
may after a lapse of a few months be killed by a subsequent injection
of the same serum. Humans who have had serum therapy sometimes
show a hyper-susceptibility to such serum when injected at a later
date. The amount of serum injected originally does not play as impor-
tant a role as some are inclined to think. The exact changes which
take place, or are responsible for this undesirable reaction or this
increased susceptibility to the foreign serum have not been satisfac-
torily explained. Those who are interested in further information on
this topic are referred to Adami, "Principals of Pathology," Volume 1,
p. 555) ; also, Rosenau & Anderson, U. S. Hygienic Laboratory, Bulle-
tin No. 29, Washington, 1906 ; Gay & Southard, Journal Medical Re-
search for 1907, p. 114; St. George T. Grinnan, Journal A. M. A.,
{200)
Volume 58, p. 178, January number ; Hektoen. Journal A. M. A., Vol-
ume 58, No. 15, p. 1081. '
The articles referred to give a very thorough and complete dis-
cussion of the principles of this hyper-susceptibility to serum which is
also spoken of as Allergy. A more complete discussion of this can be
presented at a later date if you so desire.
I do not mean to in any way discourage the use of antitoxin where
one has an undoubted case of diphtheria, or other disease where serum
therapy is indicated. The antitoxin itself has absolutely nothing to do
with this (serum sickness) anaphylactic reaction. It is the serum as
it is changed in the tissues of the person or animal into which it is
injected which produces the symptoms. The percentage of such reac-
tions is fortunately very small and it would be a crime for any one to
withhold the use of antitoxin in case of diphtheria simply on suspi-
cion that the patient might react badly to the serum.
There are more children dying each year, even in this State, for the
lack of use of antitoxin than those who die on account of the serum
reaction. Fortunately there is a means of determining whether an
individual is hyper-susceptible to the serum which consists of a small
quantity of the antitoxin serum being administered and waiting for a
few minutes to an hour for the manifestation of the reaction. If no
pronounced reaction is obtained within an hour it is usually safe to go
ahead and administer the entire dose of the antitoxin. For the per-
son who is to have antitoxin as well as for the person administering it,
it is reassuring to know that the individuals showing this hyper-sus-
ceptibility to the serum are such as have at some previous time had an
injection of a serum of some kind and those who have never had a
serum of any kind who show this phenomenon to hyper-susceptibility
are so few as to be negligible. '
(Respectfully referred to the Commanding Officer of the Florida
Militia.)
THE LESSON OF TYPHOID.
Despite the ravages of enteric fever in past wars and the brilliant
results which have followed anti-typhoid inoculation, especially in the
army and navy, the organized militia, apparently from motives of
economy, is slow to learn the lesson. While a few adjutants general
of advanced ideas have adopted the suggestions of medical officers
and have given their men the advantage of this protection against this
most common scourge of armies, others have Ireated the recommenda-
tion with little concern and have replied either that the matter might
be deferred, or that the cost of the anti-typhoid serum (about 15 cents
per man) was too great a charge on the allotment of the State.
The most recent outbieak of typhoid in a military force gives food
for serious reflection. A body of picked militiamen to the number of
more than fifty contracted typhoid fever and at least six deaths have
occurred. Nowadays we would condemn a man who refused vaccina-
tion against smallpox as a man of less than average intelligence, one
(201)
who ignored universal experience and upheld his own little narrow
ideas. If a man at the present day refused to allow his child suffering
from diphtheria to receive the anti-toxin injection, he would be con-
sidered almost criminal. What then shall we say to commanders-in-
chief, or their executive officers, who to save a few cents per man in
their State allotment, or from sheer indifference, allow the troops
under their command to be exposed to risk of disease and death which
might be prevented by an inexpensive procedure whose success has
been proven after exhaustive experimentation both here and abroad,
and which the government is willing and anxious to give to its citizen
soldiery or organized militia? — {From the Military Surgeon.)
THE BUTCHER'S LAMENT.
The meat inspector is mine enemy, I shall not like him.
He make'th me to shoo out the flies and cover the sausage mill.
He showeth me the meat I shall sell, and that I shall not.
Yea, verily tho" I scrub the ice-hox twice yearly, he sayeth ft is not
clean.
He kicketh if I keep hogs in the hack yard and sayeth it is unsanitary.
He smelleth of my sausage and heaveth it in the slop barrel, even tho*
it be but slightly sour.
He demandeth that I use not the larynx and mammae for sausage.
And he speaks in harsh tones if I disobey him.
I bringeth my meat to his office for inspection, wrapped in tree tops.
He turneth it down and insists that I wrap it in clean, white cloths.
Yea, verily, tho' mine hog grew up mine own orchard, he condemneth
it for cholera, and fly-blows, and I lose twelve dollars and a half.
He hurls threats at me if I bring not the livers and "lights," and if I
am slow about paying my bill at the month's end, he maketh me
bring the money at the time of inspection.
He anoineth my livers with kerosene and insisteth on seeing the hides
and ear-marks even tho' I tell him there is none.
Surely, the words "Clean up and stay clean" will be hurled at me all
the days of my life, and I shall live in fear of the inspector for
ever and ever. Amen.— Mulford Vet. Bulletin.
CARELESSNESS IN DIPHTHERIA.
The Xotes heartily endorses the following from the Palm Beach
Weekly Xcws of November 21, 1913 :
"The office of the Georgia State Board of Health at Atlanta was
recently compelled to close by an epidemic of diphtheria among the
officers and employes. Ten persons were affected. Only the secretary
and one other physician escaped the disease. The secretary of the
board is reported to have said that the disease was contracted from
specimens which were so carelessly prepared by the physicians who
sent them in that no indication was given of what the packages con-
tained. Ordinary envelopes, it is said, were sent in containing por-
tions of membranes placed between pieces of cardboard or paper ; other
(202)
envelopes contained cotton swabs which fell out when the package
was opened. Even if this were not a violation of the postal laws, it is
almost inconceivable, says The Journal of the American Medical Associ-
ation, that physicians could be so careless as to send in this manner
material as deadly as dynamite or an infernal machine. It not only
constituted a danger to the persons in the office of the health board,
as the sequel proved, hut it was also a menace to every one handling
the mail en route. The responsibility of physicians in handling such
material is great and the utmost precaution should be observed/'
STATISTICS.
SMALLPOX.
Reported cases of smallpox in Florida,
1,080 vaccine points distributed) :
•
November, by
counties
l
1
i
6
Escambia
1
2
5
Total cases, November 17
Deaths, November { Duval Co. ) 1
Total cases, January 1 to December 1, 1913 1,148
Total deaths reported January 1 to December 1 3
RABIES,
Report of rabies in Florida, November, by counties:
No. persons treated.
Alachua 1
Duval 3
Levy 2
Orange l
Suwanee 2
Total number persons treated, November U
Total number persons treated, January 1 to December
1, 1913 101
Total deaths from hydrophobia, January l to Decem-
ber 1, 1913 5
GLANDERS.
Report of outbreaks, by counties, November, 1913 :
Duval (in horses) 3
Total number cases, November 3
Total number cases, January 1 to December 1, 1913 (in
horses and mules) 61
hog cholera {Distribution of Serum).
Amount hog cholera serum distributed, November , +4,750 c C.
Amount hog cholera serum reported administered, November 12,145 c. c.
Number hogs reported treated, November 552
Total weight hogs reported treated, pounds 42,285
(308)
TICK ERAO 1 CATION,
Counties visited by Tick Eradication Agents of the State Board of
Health, November: Hamilton.
Places at which public demonstrations of dipping cattle were held
in November: Winn (Hamilton County).
Cattle dipping vats constructed during November (by counties) :
Orange, at Zeliwood 1
Gadsden, at State Insane Asylum 1
Pasco, at Dade City 1
Total vats built, November 3
Total number vats built to December 1 31
PUBLICATIONS ISSUED, NOVEMBER.
Supplement to Publication 92, "Rules and Regulations of the State
Hoard of Health, Public Health Statutes, and Powers and Duties."
SPECIMEN EXAMINATION, BACTERIOLOGICAL LABORATORIES
Jacksonville, Tampa,
Animal parasites
Diphtheria
Gonorrhoea
Malaria
Pathological
Rabies
Tuberculosis ,
Typhoid fever
Water (for sewage contamination),
Miscellaneous
130
696
43
138
9
11
148
M
3
24
148
147
36
249
5
2
aa
107
racola
Total.
2«)
299
96
1,139
44
123
20
407
1
15
13
23
240
14
207
* »
3
SO
121
1.4H.S 780 298 2,566
Grand total number specimens examined by State Board of Health Labora-
tories, November 2,566
DISTRIBUTION OF DISEASES DIAGNOSED IN NOVEMBER.
REPORT OF CENTRAL LABORATORY, JACKSONVILLE-
, MALARIA <
o — :
Town.
"S *■
Alachua
Altha
Apafachicola 5
Bronson
Brooker '. ..
Bushnell
Cedar Key 1
Chattahoochee . . 1
Christiana
Cocoa
•a
9
o
11
1
c
i
.g
"IT
Si
is
'5
|
i
E
B
M
C
=
3
*-,
to^
K
K
&
t-
* f
. m
2
2
■•
••
■•
1
•■
..
■■
1
1
m „
i
, ,
..
1
* -
* ■
, ,
1
4 .
1
1
2
Carried forward ■ ■ 7
10
(204
- SfALARIA
."= if
v ■?
Town. 5 C
■s- S
o ^
Brought forward . . 7
Crystal River 2
Daytona
DeLand
Dunne I ! on
Emporia
Fernandina 2
Ft. Meade
Ft. Pierce
Ft. White
Gainesville . . .... 5 3
Gaites
Hawthorne
Jacksonville 63 19
Key West
Lake Butler
Lakeland 2
Largo
Laughman
Leesburg
Mandarin
Miami
Micanopy
Morristown
Mulberry
Newberry
Ocala
Oklawaha
Orlando 2 1
Otter Creek
Oviedo
Palatka
Palmetto ..
Plant City 2
{Jmncy I
Romeo
St. Augustine 2
St. Petersburg 1
San Antonio
Sanford 7
Sarasota
Sharpe
Tallahassee 20
Titusville
Wauchuta
Specimens received
without data
il
31
I" 2
toCl
£
-2 .2
Total
.115 24
11
16
1
9
I
ID
I
3
2
1
1
2
1
■ 1
2
10
1
1
121
1
1
2
1
1
I
1
2
3
1
1
1
1
1
G
1
1
2
1
2
1
1
S
1
1
7
1
1
23
2
2
21
30
40 249
(205)
REPORT OF TAMPA LABORATORY.
■MALARIA-
Ton'ti,
Tampa 26
Lakeland 2
Bradentown
Ft. Myers
Knights Station
Dade City
Plant City .- 1
Manatee - . . 2
Kathleen
Sydney
St. Petersburg
Tarpon Springs
Clearwater
(J bis O
13 1
t s.i
5
1
IS
hi
2
■3
C
13
1
Total
. .. 31 15 1 .. 10 7 10
REPORT OF PENSACOLA LABORATORY.
22
Pensacola
DeFuniak Springs. .. , ,
Campbeltton
Bonifay 1
Marianna 5
Milton 1
Holt
Tallahassee
Millville 2
16
Total
16
102
6
2
1
1
1
1
2
1
1
1
1
1
16 121
28
1
1
1
5
1
1
1
2
41
Total cases of principal diseases diagnosed by Laboratories of the
State Board of Health during November:
Diph- Go nor- Tuber- Hook-
theria. rkoea. Malaria. Typhoid, ctilosis. worm.
Central Laboratory 115 24 13 21 36 40
Tampa Laboratory 31 15 18 19 22 16
Pensacola Laboratory ..9 18 1 2 7 6
Total for State 155 55 33 42 65 62
VITAL STATISTICS.
PROGRESS.
In the August issue of Health Notes appeared an article on
"Vital Statistics," outlining the plan to collect birth and death reports
in the cities of the State of 2,000 population and over. Several num-
bers since have reported the progress of this plan.
It is gratifying now to be able to report that of the twenty-eight
cities (counting Tampa and West Tampa as one), twenty-seven have
(206)
appointed Registrars or provided for the collection and return of re-
ports to this office for the ensuing year. These cities, in order of pop-
ulation, are :
Jacksonville, St. Petersburg, Daytona,
Tampa and West Tampa, Ocala, DeLand,
Pensacola, Lakeland, Apalachicola,
Key West, Orlando, Plant City,
Gainesville, Sanford, Port Myers,
Miami, Live Oak, Bartow,
St. Augustine, Quincy, Tarpon Springs,
Tallahassee, Palatka, Kissimmee,
Lake City, Fernandina, Marianna.
Most of these cities are now reporting and with one exception the
balance 'have arranged to begin January 1st, next. The exception is
Fort Myers, which has appointed the Registrar but has not yet passed
any ordinance making compulsory the reporting of births and deaths.
DeFuniak Springs, the nineteenth among the above, is the one
city from which nothing definite has been heard, but it is understood
an ordinance was being prepared, and by this time it may have been
passed.
REQUISITES FOR SUCCESS.
The greatest need in this work is the support of public sentiment
favoring it as necessary information that each community should accu-
rately know of its health conditions. This both to induce newcomers
to settle and to indicate needful sanitary reforms.
It is impossible for a community to induce newcomers to settle un-
less "health is reasonable. Health conditions cannot be proven from
local statements. If the necessary accuracy is obtained, claims of
healthfulness can be corroborated by these official records.
Without public sentimeut to stand back of the ordinances and so
help physicians, and make mid wives report, Registrars, no matter how
faithful, will not be likely to obtain accurate returns.
Those cities which have not passed adequate ordinances or appoint-
ed Registrars, should do so at once, and all citizens should loyally sup-
port the Registrars and ordinances when appointed and passed and see
that the law is fully complied with.
REAL HEROISM.
To live well in the quiet routine of life ; to fill a little space because
God wills it; to go on cheerfully with a petty round of little duties,
little avocations ; to smile for the joys of others when the heart is ach-
ing — who does this, his works will follow him. He may not be a hero
to the world, but he is one of God's heroes. — Dean Farrar.
Restaurant Patron (caustically) — I am glad to see your baby has
shut up, madam.
Mother — Yes, sir. Yoti are the only thing that's pleased him since
he saw the animals eat at the Zoo. — Puck.
(207)
ANOTHER VIEWPOINT.
The Notes has so frequently insisted that the injunction, "Thou
slialt not kill," applied as much to the indifference of civic authorities
to remedy and prevent the occurrence of unsanitary agents destructive
to life as it did to the assassin or murderer ; therefore it is refreshing
to notice in the daily press of the State that there is an awakening to
this fact, and that there are editors in Florida who boldly declare that
there is more than one way of "killing" than by gun or dirk, and that
a failure to protect life, by adopting preventive measures against
disease is as criminal an act as when life is destroyed by violence. The
Notes thanks the Miami Metropolis for the following most excellent
comment on this question of killing :
"THOU SHALT NOT KILL."
Twelve good men and true rendered a verdict of first degree
murder in the case of a man accused of killing a neighbor and robbing
his house. The day was set for the execution. A few minutes before
the prisoner w^ent to the scaffold he confessed his guilt and he was
hanged by the neck until he was dead.
The penalty was a deserved one and society had been protected.
It is a heinous thing to take a life and rob a home.
The twelve good men and true were "leading citizens" and upon
them devolved much of the town's management. In the town were
places where flies and mosquitoes were hatched by the million, near the
town were dairies where milk was sold from diseased cows and
delivered in receptacles unsanitary and germ laden. Every year in this
town were numerous deaths from typhoid fever and malaria, there
were cases of tuberculosis and cholera infantum, but no one ever thought
of having a trial and accusing these twelve good men and true of being
responsible for the death of the town's beloved.
In the case of the man who was hanged by his neck until he was
dead the demon Greed drove him to the house of the neighbor where
a roll of bank notes were known to be — the neighbor undertook to
protect his money and was killed.
In the other case, it was still the demon Greed that drove these
twelve good men and true to feign blindness to unsanitary conditions.
It would have cost money to get rid of the flies and the mosquitoes and
to clean up the dairies — no one had ever brought it right home to
them that they were murderers in even a more despicable way than was
the thief. He did it knowing that the law would probably get him at
last — they did it knowing that it was a perfectly protected crime.
And even if you smile at the seemingly ridiculous classification of
those twelve good men and true with that common murderer, you can
not think with any depth and not agree that the crime of the twelve is
more reprehensible than the other.
It is a heinous thing to take a life and rob a home.
(206)
appointed Registrars or provided for the collection and return of re-
ports to this office for the ensuing year. These cities, in order of pop-
ulation, are:
Jacksonville, St. Petersburg, Daytona,
Tampa and West Tampa, Ocala, DeLand,
Pensacola, Lakeland, Apalachicola,
Key West, Orlando, Plant City,
Gainesville, - San ford, Fort Myers,
Miami, Live Oak, Bartow,
St. Augustine, Quincy, Tarpon Springs,
Tallahassee, Palatka, Kissimmee,
Lake City, Fernandina, Marianna.
Most of these cities are now reporting and with one exception the
balance have arranged to begin January 1st, next. The exception is
Fort Myers, which has appointed the Registrar but has not yet passed
any ordinance making compulsory the reporting of births and deaths.
DeFuniak Springs, the nineteenth among the above, is the one
city from which nothing definite has been heard, but it is understood
an ordinance was being prepared, and by this time it may have been
passed.
REQUISITES FOR SUCCESS.
The greatest need in this work is the support of public sentiment
favoring it as necessary information that each community should accu-
rately know of its health conditions. This both to induce newcomers
to settle and to indicate needful sanitary reforms.
It is impossible for a community to induce newcomers to settle un-
less health is reasonable. Health conditions cannot be proven from
local statements. If the necessary accuracy is obtained, claims of
healthfulness can be corroborated by these official records.
Without public sentiment to stand back of the ordinances and so
help physicians, and make mid wives report, Registrars, no matter how
faithful, will not be likely to obtain accurate returns.
Those cities which have not passed adequate ordinances or appoint-
ed Registrars, should do so at once, and all citizens should loyally sup-
port the Registrars and ordinances when appointed and passed and see
that the law is fully complied with.
REAL HEROISM.
To live well in the quiet routine of life; to fill a little space because
God wills it; to go on cheerfully with a petty round of little duties,
little avocations ; to smile for the joys of others when the heart is ach-
ing — who does this, his works will follow him. He may not be a hero
to the world, but he is one of God's heroes. — Dean Farrar.
Restaurant Patron (caustically) — I am glad to see your baby has
shut up, madam.
Mother — Yes, sir. You are the only thing that's pleased him since
he saw the animals eat at the Zoo. — Puck.
(207)
ANOTHER VIEWPOINT.
The Notes has so frequently insisted that the injunction, "Thou
shalt not kill," applied as much to the indifference of civic authorities
to remedy and prevent the occurrence of unsanitary agents destructive
to life as it did to the assassin or murderer; therefore it is refreshing
to notice in the daily press of the State that there is an awakening to
this fact, and that there are editors in Florida who boldly declare that
there is more than one way of "killing" than by gun or dirk, and that
a failure to protect life, by adopting preventive measures against
disease is as criminal an act as when life is destroyed by violence. The
Notes thanks the Miami Metropolis for the following most excellent
comment on this question of killing:
"THOU SHALT NOT KILL."
Twelve good men and true rendered a verdict of first degree
murder in the case of a man accused of killing a neighbor and robbing
his house. The day was set for the execution. A few minutes before
the prisoner went to the scaffold he confessed his guilt and he was
hanged by the neck until he was dead.
The penalty was a deserved one and society had been protected.
It is a heinous thing to take a life and rob a home.
The twelve good men and true were "leading citizens" and upon
them devolved much of the town's management. In the town were
places where flies and mosquitoes were hatched by the million, near the
town were dairies where milk was sold from diseased cows and
delivered in receptacles unsanitary and germ laden. Every year in this
town were numerous deaths from typhoid fever and malaria, there
were cases of tuberculosis and cholera infantum, but no one ever thought
of having a trial and accusing these twelve good men and true of being
responsible for the death of the town's beloved.
In the case of the man who was hanged by his neck until he was
dead the demon Greed drove him to the house of the neighbor where
a roll of bank notes were known to be — the neighbor undertook to
protect his money and was killed.
In the other case, it was still the demon Greed that drove these
twelve good men and true to feign blindness to unsanitary conditions.
It would have cost money to get rid of the flies and the mosquitoes and
to clean up the dairies — no one had ever brought it right home to
them that they were murderers in even a more despicable way than was
the thief. He did it knowing that the law would probably get him at
last — they did it knowing that it was a perfectly protected crime.
And even if you smile at the seemingly ridiculous classification of
those twelve good men and true with that common murderer, you can
not think with any depth and not agree that the crime of the twelve is
more reprehensible than the other.
It is a heinous thing to take a life and rob a home.
(208)
REGISTRARS OF VITAL STATISTICS.
WILL PLEASE NOT FAIL
To send in reports promptly.
To have all certificates legibly written in unfading ink.
To have every item possible answered ; if information cannot be had,
answer "Unknown."
To sign every certificate as Registrar,, with date of filing.
To copy each birth and death certificate in local register the day cer-
tificate is filed.
To have place of birth or death stated definitely, showing whether it
occurred within city limits.
To require date of birth or death.
To have all birth certificates specify whether "born alive" or "still-
born."
To require both a birth and a death certificate for stillbirths.
To have midwives or others unable to write, sign certificates with
their marks.
To require statement of sex.
To require statement of color or race.
To require statement as to whether legitimate, or born out of mar-
riage.
To require a certificate of birth for each chdd born in case of plural
births, specifying order of birth for eacn.
To have stated in birth certificates number of children born to mother
and number now living.
To require the maiden name of mother, not the name after marriage.
To require informant's signature and address on every death certifi-
cate.
To require the approximate age, when the exact age is unknown.
To have doctors properly assign cause of death, and avoid Undesir-
able Terms.
To require signature and address of undertaker, or the person acting
as such.
To have a sufficient number of blanks on hand at all times.
To require any person who has neglected to file a birth or death cer-
tificate to do so immediately.
To enforce your ordinance when it is wilfully violated.
To number birth and death certificates consecutively, those that occur
on or after January 1, 1914, in a new series, beginning with Num-
ber 1 for the first "birth and the first death.
To make out bills in duplicate.
—Acknowledgments to Mississippi Health Bulletin.
INDEX TO VOLUME VIII.
A
FACE.
Acts (See Sewage Law— Cattle Tick Eradication Bill).
Age— "Always Growing Old" 186
Anaphylaxis 199
B
Baths— Cold Water 162
Biliousness — "Two Common Fallacies" 37
Book Reviews 112
Butcher's Lament, The 201
Byrd, Dr. Hiram — Announcement of Resignation 144
Calendar for 1913 4, 6. 8, 10. 13, 14, 16, 18, 20, 22, 24, 26, 28
Cattle Tick Eradication Bill as Passed by the Legislature 121
Cattle Tick Eradication — The Medical Man and 43
Child Hygiene — Some Thoughts on 171
Children :
Retardation of Development 23
The Feeding of Infants and 29
Closets (See Surface Closets).
Colds ,....,....., , ,.....,..,,... '. 183
Communal Crime 13
Consumption — "Movies Will Show Fake Consumption Cure Evil" 1B2
Diphtheria 5
Carelessness in 201
Carriers 5
Management of Carriers , 132
Suggestions to Physicians Regarding 179
Diseases — Sewage Borne 21
Dogs — Rabid (See Rabies).
Drugs — Emergency Supplies for the Home. * 42
Election of Officers of the State Board of Health 112
Embalmers' Examination — Notice of 64
Epidemics — Concealment of 4tt
Examination of Embalmers (See Embalmers' Examination).
F
Flies :
How Fiies Transmit Typhoid 17
Showing How Housefties Breed 170
G
Germs :
Another Way to Make Useful, 136
A New Use for 39
ah
H
Health : PAr,fi.
"Nature's Daily Demands" 194
Public Health Purchasable (See Public Health).
Rightful Living and — "Listen'' 82
The Secret of 2
The Students' Health Creed..... 91
Heat— "The Art of Keeping Cool" 139
Hog Cholera T
Home Snuggery — A ,. 63
Hookworm :
Eradication of, in North Carolina 46
Infection Through Skin 35
What Everyone Should Know About 13
Hosts- — Intermediate (See Intermediate Hosts),
Hydrophobia in Florida , 58
Hygiene — Some Thoughts on. (See Child Hygiene.)
I
Ice Cream — The Manufacture of 149
Imhoff Tanks (See Sewage Disposal).
Infantile Paralysis 27
Infants — "The Feeding of Infants and Children" 29
Intermediate Hosts 21
K
Kidney Trouble — "Two Common Fallacies" 37
Kipling, Rudyard— "If" (Poem) 32
L
Laboratory Specimens :
Advice Regarding Collection of Blood Specimens for Malaria , 185
Mailing Requirements 146
Notice of Mailing Regulation 36
Suggestions to Physicians with Regard to 166
Legislation, Public Health — "Good Advice" 84
Leprosy 98
Leprosv — A Note Regarding the Apparent Cure of Two Lepers in Manila . . 152
Life— The Cost of 148
Lockjaw (See Tetanus or Lockjaw).
M
Malaria :
Advice Regarding Collection of Blood Specimens for (See Laboratory
Specimens).
For Prevention of 45
The Prevention of 51
Marriage — "Why Do Married Men Live Longer" 151
Morbidity — "Some of Humanity's Needless Burdens" 25
Mortality — "Some of Humanity's Needless Burdens'' !f5
Mosquitoes 66
N
Nurses for the Public Health 185
o
Obituary — M r. Wm. Kopman Hyer 48
(HI)
P
PAGE.
Paralysis — Infantile (See Infantile Paralysis).
Pathological Tissues— Suggestions to Physicians Regarding. 180
Pellagra :
In the United States 137
What We Don't Know About , 27
Pneumonia 11
Poliomyelitis (See Infantile Paralysis).
Public Health :
A Brief Compendium of 142
Purchasable - 141
Some Tested Truths of 29
Public Health Administration :
"Another Viewpoint" 307
"Fear versus Reason" 38
"Why Blame Providence" 171
Public Health Legislation (See Legislation),
Quarantine:
In Smallpox '. 91
"Just What Is Quarantine, Anyway" IB4
R
Rabies :
Comments of Senior Bacteriologist 180
In Florida 114
"Read and Heed" us
"What Is a Dog Worth" 162
Registrars (See Vttat Statistics).
S
Scarlet Fever— Difficulty in Control of 127
Screening — Definition of Screening Law 35
Screens— Diseases Prevented by 17
Septic Tank — The Biology of Sewage Purification and the Function of 153
Sewage Borne Diseases (See Diseases).
Sewage Disposal 122
Sewage Disposal— Imhoff Tanks. 198
Sewage Law — -New 138
Sewer Systems — Rat Proofing of Municipal 181
Smallpox 9
Diagnosis of 61
H emorrhagic 60
Vaccination (See Vaccination).
"What to Do in Case of" 39
Specimens (See Laboratory Specimens).
Spleen— "Don't Be An Easy Mark" 48
Squibs :
"A Retort Courteous" 160
"Contagion" 17
"Couldn't Reciprocate" 84
"Franklin and the Bore"
"Good News" 1
"Ingersoll's Reply" M
"Jap Baker's Sign" 63
"Proper Ammunition" 12S
"Puppy Dog No Relation" 17'
(IV)
Squibs — Continued : page.
"Real Heroism" 206
"Seven-Day Fever" 47
"The Worst Yet" 47
Statistics .61, 92, 110, 142, 157, 172, 188, 202
Statistics— Vital (See Vital Statistics).
Surface Closets — For Making Flyproof 187
Tetanus or Lockjaw : 19
Tick Eradication (See Cattle Tick).
Tuberculosis — Laboratory Diagnosis of .\ 133
Tuberculosis — Treatment of 125
Tuberculosis in Cattle — "The Referendum and Tuberculous Dairy Herds". , , 43
Typhoid :
How Flies Transmit 17
In Washington 47
The Lesson of 200
Typhoid and the Fly 140
u
Underwear — Woolen 178
V
Vaccination — Smallpox :
"Another Object Lesson" 89
"As Others See" 87
"Brains versus Idiocy" 83
"Dr. Osier's Challenge to the Anti-Vaccinationist" 90
Education 35
In the Army 151
Opinion of Dr. Watson 90
"The Breaking of Dawn" 34
"The Hall Mark of Ignorance" 89
Ventilation — Air Space and 7
Vital Statistics:
Extension in the United States , . 175
Importance of 191
Plan of Collection .-. 130
Progress in Florida 159, 205
Registers of 208
Reminder 192
w
Water Analyses — In connection with Typhoid Fever. 134
Y
Yaws— Household Cleanliness and » 64
ILLUSTRATIONS.
Cattle Tick 3
Smallpox 9
From Flies and Filth to Food and Fever 15
Vaccination 40-41
Quarantihe 50
Surface Closet Fly-Proofing Device 187
„."'■
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